JOB DESCRIPTION. Consultant in Histo/Cytopathology. Royal Surrey County Hospital, Guildford, Surrey. Clinical Director Director of Pathology Services

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1 JOB DESCRIPTION Title: Consultant Histo/Cytopathologist Salary Range: 76, ,490 Base: Specialty: Accountable to: Royal Surrey County Hospital, Guildford, Surrey. Pathology Access and Acute Medicine, Womens and Children Portfolio Clinical Director Director of Pathology Services Job Summary: This is a replacement post is for Consultant Histo/Cytopathologist based at and employed by the Royal Surrey County Hospital, Guildford as part of Berkshire and Surrey Pathology Services with Frimley Health, Ashford St Peters Hospital and Royal Berkshire Hospital. This is a full time position comprising 10 programmed activities to be split between reporting Histology and Cytology. Any consultant who is unable for personal reasons to work full time 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 in consultation with the Histology/Cytology Speciality Leads and Consultant colleagues. The post holder must be medically qualified with full and Specialist registration (and with a licence to practise) with the General Medical Council (GMC), or be eligible for registration within six months of interview. The post holder should also hold a CCT (or be within 6 months of the award of CCT or equivalent) and will be required to have the Fellowship of Royal College of the Pathologists or show evidence of equivalent. A record of special experience in one or more areas of histopathology particularly in the aspect of cancer pathology is highly desirable as well as experience in Cytology especially in the areas of Head and Neck/Thyroid cytology. Main Duties & Responsibilities: The post holder with the existing consultants will provide a histology service to Health Authority Commissioners, GPs and clinicians at the hospitals as well as to the Jarvis Breast Screening Centre. Duties will include participation in weekly and/or monthly meetings, with the clinicians in the form of clinicopathological and MDT meetings to discuss patient management. The Cytology aspect of the role would involve the reporting of non gynae cytology across the Surrey hub and will also include attendance at relevant MDT s. Gynae cytology reporting would be optional. The department will be adopting subspecialty reporting in future so that each consultant would have a responsibility for 2 3 areas of interest. The post holder will participate in a rota of medical staff so that each individual reports a proportion of the designated type of specimen that is appropriate for his subspecialty ensuring safe and best practice. However, if the applicant does not yet have a special area of interest they should be prepared to

2 develop an interest which would complement the existing expertise. Urgent reporting of specimens from the surgical clinics at the hospitals is part of the service provided. The Royal Surrey County Hospital is a recognised Calman Cancer Centre and the successful candidate will be involved in the special cellular pathology services required by such a centre. Specialist Registrars rotate within cellular pathology at RSCH on a 6-12 monthly basis and supervision and teaching of the junior medical staff is a necessary part of this post. In particular the provision of non gynae cytology training will be expected as part of this role. The post holder will have an option of participating in coroner s post-mortem service rota and/ or supervision of registrars in post-mortem examination. The post holder will be expected to participate in the Regional EQA Scheme for histopathology and the CPD scheme of the Royal College of Pathologists. The post holder will also be required to take part in suitable specialist EQA Schemes related to their designated areas of special responsibility, where such schemes are in existence. The department is well equipped with automated rapid processors and automated immunostainers. The range of immunochemistry is very wide and requests for any additional new antibodies are usually considered favourably. The department does not provide services in neuropathology or paediatric pathology and requests in these areas are referred to St George s Hospital in Tooting. Facilities for audit and funding for study leave are available. The Consultant will also be expected to: 1. In conjunction with Consultant and Senior colleagues, to provide a service in. 2. To provide cover for Consultant and Senior colleagues in respect of periods of leave. 3. In conjunction with Consultant and Senior colleagues, to take part in medical audit and research as appropriate. 4. In conjunction with Consultant and Senior colleagues, to ensure that the requirements of clinical governance are met. 5. To ensure that there are adequate arrangements for hospital staff involved in the care of your patients to be able to contact you when necessary. Junior Medical Staff 6. In conjunction with Consultant and Senior colleagues, to play a full part in the professional supervision, management and training of junior medical staff. 7. In conjunction with Consultant and Senior colleagues, to take responsibility for and devote time to teaching, examination and accreditation duties as required for junior medical staff. Management & Service Development 8. In conjunction with the Operations Director/Specialty Manager, Consultant and Senior Colleagues, to take an active role in the management of the Business Unit. 9. In conjunction with the Operations Director/Specialty Manager, Consultant & Senior colleagues, to play a full part in developing & implementing new ways of working in line with modernisation principles and fit for the future. 10. In conjunction with Consultant and Senior colleagues, to take responsibility for the best use of departmental staffing and other resources to ensure the maximum efficiency 11. To observe the Trust s agreed policies and procedures, in particular in relation to managing staff, and to follow the Trust s Standing Orders and Standing Financial Instructions. These policies and procedures have been drawn up in consultation with the profession on clinical matters.

3 Provisional Timetable/Job Plan: The work programme will consist mainly of clinical diagnostic duties including rotation with the other consultants and training junior pathologists but will also include some aspects of administration, clinical audit and special clinical or research interest. The timetable will be agreed with the Specialty Leads and other Consultants and will be organised flexibly to respond to clinical need and service development. The department is in the process of adopting a form of subspecialty reporting and this will involve closely working with a team of one or more consultant pathologists sharing and leading the MDTs relevant to their areas of special interest to provide a diagnostic service for a specified group of clinicians. This involves them being the point of contact for the relevant Tumour Working Group and organising the pathological aspects of the MDT meeting. The timings given are average times for the activities indicated. The balance of the job plan in terms of DCC sessions delivered will equate to 8 DCC: 2 SPA (pro rata) in accordance with Trust policy. Monday Tuesday Wednesday Thursday Friday Reporting of Histology with the trainee 1PA Non Gynae Reporting 1PA Reporting of Histology with the trainee 1PA Head & Neck/Thyroid Cytology MDT 1PA Audit 0.5SPA Reporting of Histology with trainee CPD 1SPA Reporting of Histology with the trainee 1PA Management meeting (twice monthly) alternating with research 0.5SPA Cut up 0.5PA DCC Non Gynae Reporting 2 PA Reporting of Histology with the trainee 4.5PA MDT 1PA Cut Up 0.5PA SPA CPD 1PA Meeting/Research 0.5PA Audit 0.5PA Non Gynae Reporting 1PA 0.5PA Reporting of Histology with the trainee 1PA Notes: It is expected that there will be some flexibility around the timing of any duties and activities, reflecting role development. It is, of course, also expected that clinical need of patients will always take precedence over other activities in the job plan. On Call: There is no on call commitment

4 Resources: BERKSHIRE AND SURREY PATHOLOGY SERVICES At present Surrey Pathology Services is a single NHS Pathology directorate serving Ashford and St Peter s Hospital, Frimley Health (Frimley Park Hospital and Heatherwood and Wexham Park Hospital) and Royal Surrey County Hospital NHS Foundation Trusts including St Luke s Cancer Centre with a combined catchment population of approximately 1.2m. As a part of pathology service reconfiguration and the formation of Berkshire and Surrey Pathology Services (BSPS) the Histology department is being centralised at Royal Surrey County Hospital for the Surrey area with a view to developing full subspecialisation over the next months. The department is well equipped with automated rapid processors and automated immunostainers. The range of immunochemistry is very wide and requests for any additional new antibodies are usually considered favourably. The department does not provide services in neuropathology or paediatric pathology and requests in these areas are referred to St George s Hospital in Tooting. Facilities for audit and funding for study leave are available. The Gynaecological cytology service has been centralised at St Peters Hospital. The nongynae cytology service is now centralised at St Peter s Hospital as part of the ongoing reconfiguration of the service. This is a progressive department with ambition to develop a strong molecular service and academic links through the clinical academic group status with the University of Surrey and its Veterinary School as well as maintaining links with Royal Holloway. A rapid response laboratory service in Clinical Biochemistry and Haematology is provided on all BSPS sites to support the in-patient and out-patient work. Analysis of general practice samples will be consolidated into 2 hubs, at Frimley Park for the Surrey area and Wexham Park for the Berkshire area. Specialist Biochemistry is concentrated at Guildford. The technical functions in Histopathology and Cytopathology are located at Guildford and Chertsey. All Microbiological laboratory investigations are performed on the Frimley/Wexham Park sites, with Virology and Immunology centralised on the ASPH site. The merged laboratory is served by a single IT system, the three sites being linked by a mega-stream connection. The current IT system is Clinisys Winpath but a new system Clinisys Enterprise is currently being developed to cover the entire BSPS network. Berkshire and Surrey Pathology Services has its own transport department to support its activities. The merged directorate has a single Director, a Chief Operations Officer, Speciality Leads and General Managers covering all departments and sites. All departments have full CPA accreditation. Management arrangements and role of Consultant Pathologists/Clinical Scientists within the directorate conform to the Strategic Review of Pathology Services (1995) paragraphs (inclusive). The Histopathology department at RSCH is a large training department associated with a cancer centre and University both requiring a high diagnostic standard and a desire to participate in research and teaching. It is involved with research programmes in colorectal, breast and skin pathology and organises educational and EQA schemes. There is a particular interest in skin cancer and the department has been selected as one of the European centres for further funded study of the histology of metastatic melanoma in

5 sentinel lymph nodes and prognostic features of primary melanoma. Molecular Pathology is currently sited within the department of histopathology although separately administered. It will provide an appropriate range of services in collaboration with the other disciplines of Pathology. It is hoped that the successful applicant will aid the development of molecular pathology with respect to histopathology in particular its role in cancer pathology. The Department of Cytopathology is based on the Royal Surrey, St Peter s and Wexham Park sites. Overall the department undertakes gynaecological cytology and nongynaecological cytology cases including semen analysis and a large number of breast FNAs. The department at St Peter s provides an attendance by laboratory staff at FNAs wherever possible for assessment of adequacy. The departments currently hold full CPA accreditation for both Histology and Cytology. The Department is in the processing of applying for ISO accreditation and would expect to be inspected early in 2017, dates awaited. DEPARTMENTAL STAFFING (Surrey) ASPH 5 consultant Histopathologists Consultants: Dr Susan Dodd Dr Meeta Pradhan (reports Cytology) Dr Babikir Ismail Dr Jhulan Biswas (reports Cytology) Vacant post Associate Specialist Dr Sujatha Balija Specialty Doctor Dr Kowsala Rajartham Consultant Clinical Scientist Dr Behdad Shambayati (Cytology Specialty Lead) FPH 6 Consultant Histopathologists. Consultants: Dr Christopher Smith Dr Salome Beeslaar Dr George Kousparos Dr Anna Silvanto Dr Maria Bahhadi-Hardo Vacant post

6 RSCH 7 consultant Histopathologists, one new post starting in Feb and this vacant post. Consultants: Dr Izhar Bagwan (Specialty Lead) Dr Peter Jackson Prof Martin Cook Dr Ben Haagsma Prof Silvana Di Palma Dr Poonam Pingle Dr Hitesh Matthew Specialty Doctor Specialty Registrar Clinical Assistant Dr Maryam Khan (Histology) Dr Ros Bartle Jones (Cytology) Dr Julia Baxendine-Jones (Cytology) HWPH 5 Consultant Histopathologists Consultants: Dr Rezan Gardy Dr Gareth Turner Dr Wassim Al Salti Dr Mabel Thyveetil Dr Shaila Desai Dr L Perry (cytopathologist) Associate Specialist: Dr D Tsang Dr S Ghani Specialty Doctor: Dr P Hamal RBH - 7 consultant Histopathologists: Dr Fawaz Musa Dr Colin McCormick Dr Charles Lewis Dr Gearoid Kingston Dr Hanan El-Mahallawi Dr Yasser Moghaddam Dr Sukhvinder Ghataura 1 x General Manager Cellular pathology 8c Technical (combined across all sites): 2 x Band 8b 2 x Band 8a BMS x Band 7 BMS x Band 6 BMS x Band 5 12 x Band 4 MTO 2 10 x Band 3 MLA 4 x Band 2

7 Mortuary: 5 x Leads 12 x APT/Trainees 1 x Admin assistant Molecular Biology: (RSCH) 1 x Clinical Scientists (0.4 wte) 1 x Trainee Clinical Scientist 1 x BMS2 1 x BMS 1 x MLA IT Specialist: 0.5 wte Admin and Clerical Combined including MDT cover 28 staff across all sites. MANAGEMENT ARRANGEMENTS FOR THE PATHOLOGY SERVICE The Director of Berkshire and Surrey Pathology Services is accountable to the Berkshire and Surrey Pathology Service Board for the provision of an appropriate, effective and comprehensive pathology service. The BSPS Board includes the Chief Executives and Financial Directors of the four Trusts and is accountable to the individual Foundation Trust Boards. Each discipline within Pathology is managed by a Specialty Lead (a medical consultant or clinical scientist of similar standing who is responsible for clinical leadership and the overall provision of a professional service) assisted by a General Manager (a senior biomedical scientist responsible for the effective management of laboratory functions). The Specialty Leads are directly appointed by the Director and Medical Director of SPS. There is no specified term of office, but performance is subject to annual appraisal and appointees must continue to command the confidence of other consultants within the discipline. Budget The current ( ) annual budget for the Cellular Pathology service is 4.1 million. The delegated budget holder is the specialty lead consultant, with the budget manager being the General Manager for Cellular Pathology.

8 HISTOPATHOLOGY DEPARTMENT WORKLOAD For 2015/2016 the workload for the 5 sites was: RSCH = ASPH = FPH = HWXP = cases Blocks cases Blocks cases Blocks cases Blocks RBH = cases Blocks In total IHC slides were stained across all sites. CYTOLOGY DEPARTMENT WORKLOAD For 2015/2016 the non gynae workload for the 4 sites was: RSCH/FPH= 7324 cases ASPH = HWXP = RBH = 2956 cases 2130 cases 3909 cases The combined gynae workload was 120,653. Research and Development The post-holder will be encouraged to participate in and generate research projects in the department and when appropriate supervise projects undertaken by trainee pathologists and Biomedical Scientists. There are strong opportunities for joint research projects with the University of Surrey and other collaborations are envisaged. The facilities of the School of Biomedical and Molecular Sciences could be available for appropriate studies by the successful applicant Appraisal/Revalidation: At the Royal Surrey County Hospital Foundation Trust we support the implementation and monitoring of all current revalidation requirements as identified by the Department of Health and the revalidation support team. We provide advice and information to medical staff on appraisal/revalidation process and systems and ensure all doctors are participating in an annual appraisal. We co-ordinate and provide training for medical staff in preparation for appraisals to meet the requirement for revalidation.

9 Mentoring: New consultants are offered a mentor by the Trust to support professional development during the transition from higher specialist training to Consultant. Admin Support & Office Space The Consultant will be provided with PC access to the Trusts information systems, internet and Trust intranet, as well as secretarial and administrative support. Separate office space will be provided within the department with a microscope. Study Leave & Continuing Professional Development: Study and professional leave will be granted at the discretion of the department and in accordance with Terms and Conditions, and the Trust s policies and procedures. The appointee will be expected to participate in clinical audit and CPD The Trust supports the concepts of CPD, clinical audit and EQA, and encourages all consultants to participate in these activities by providing time and resources. Speciality lead posts are for a fixed term and appointed by interview. The post holder will be eligible for appointment to the posts of relevant speciality lead and director of pathology when vacancies arise Clinical Governance The Clinical Governance structure is managed by a Clinical Governance Committee chaired by the Medical Director and consisting of several individual sub committees covering R&D, Education, H&S, Quality, POCT, Risk management and User and Patient Experience. These groups meet on a regular basis and feed into the Clinical Governance Committee on a quarterly basis. Teaching & Post Graduate Education: The department is a training centre for Specialist Registrar in Histopathology based at and employed by the Royal Surrey County Hospital, Guildford. There are also LAS positions and specialty doctors. They all receive an induction and formal assessment by educational supervisor and one to one teaching/ training. The main medical library is in the Postgraduate Education Centre at the Royal Surrey County Hospital where the books and journals are kept. Subscriptions are held with lending libraries. Journals and photocopying arrangements with the National Lending Library are available to all doctors to study. There are also tape, slide, and video tape and internet facilities. The main library is fully staffed by librarians. The Regional Library and the Regional Drug Information Service are based at the Postgraduate Centre. Surrey University Campus is adjacent to the hospital and provides excellent opportunities for collaboration in research. The New Postgraduate Medical School building opened in 2005, and houses the MATTU (minimal access therapy training unit). The European Institute of Health Studies which is situated in Guildford provides training for nurses, midwives and other health care professionals both from the Trust and throughout West Surrey Health Authority. The University of Surrey provides BSc (Hons) Nursing Degree programme.

10 Terms and Conditions of Service: Terms and Conditions of service will be those applicable to the new Consultant Contract and any offer of employment is subject to satisfactory Occupational Health clearance as per Clothier Report recommendations. The appointee must not start work until this clearance is received. Employment will also be governed by the Trust s employment policies and procedures. The appointee will be required to live no more than 30 minutes drive from the Trust, unless specific approval is given to a greater distance by the Chief Executive General Information - Royal Surrey County Hospital NHS Foundation Trust: The Geography Situated on a green field site on the outskirts of Guildford, the Trust has excellent rail and road links (via the A3 and M25) to London (35 minutes) and to the south coast (35 minutes). A shuttle bus service links the hospital to the railway station and town centre, and the main taxi ranks. The picturesque Surrey countryside is ideal for good walks and outdoor pursuits and has numerous historic village inns. Guildford is one of the best shopping areas outside London centred on its attractive high street, and entertainment for all tastes including clubs, restaurants, theatres, cinema and a new multi-sports complex with swimming pools, ice rink, gymnasium and ten pin bowling. Guildford has a number of schools, both private and state, which cater for all bands of ability. There is a Technical College, with a wide and varied curriculum and a Law College with a national reputation. The University of Surrey is situated beside the Cathedral, adjacent to the A3 trunk road. There is mainline rail link with London and the South West. The Royal Surrey County Hospital NHS Foundation Trust The Royal Surrey County Hospital NHS Foundation Trust is a leading modern general hospital and specialist centre for cancer services and treatment, based in Guildford. The RSCH serves a population of 320,000 for emergency and general hospital services, mainly from West Surrey, East Hampshire and North Sussex and 1.2 million people for cancer services. The hospital has an annual income of more than 200 million and employs around 3,000 people. In particular, there have been a number of recent additional consultant appointments bringing the total number of consultants employed to 143. Every year the RSCH sees around 215,000 outpatients, admits 58,500 patients for treatment and 72,000 patients attend our A & E department. The Trust is also a centre of excellence and training for minimal access surgery and regional hub for ENT and pathology services. Specialist services include Dermatology, ENT, Gastroenterology, Paediatrics, Respiratory Medicine and Rheumatology. We were licensed as an NHS Foundation Trust on 1st December 2009 and our vision for the future is to continue to develop both as a modern hospital and as a cancer centre. Our focus

11 is to deliver the best possible care for our patients, with excellent treatment and outcomes and be the employer of choice. The Royal Surrey has the 13th lowest mortality rate in the country and is one of the Top 20 safest hospitals. Postgraduate Medical School University Of Surrey The University of Surrey has become one of the leading academic institutions of the country. In the recent University Research Assessment exercise it came 4th in the UK for most academics based in 5*A rated departments. Surrey University Campus is adjacent to the hospital and provides excellent opportunities for collaboration in research. The New Postgraduate Medical School building opened adjacent to the hospital in 2005 and provides state of-the-art facilities for medical research. All prospective post-holders will be expected and encouraged to perform research. Confidentiality All employees must respect and protect the confidentiality of matters relating to patients or other members of staff and must comply with the requirements of the Data Protection Act (1998). Further details are available from the Trust s Data Protection Act Designated Officer. Corporate Governance The Trust, as a public organisation, is committed to acting with honesty, with integrity and in an open way. The Trust Board of Directors is responsible for ensuring that Trust services are managed in this way. We are working together to achieve the highest levels of compliance with the risk management standards promoted through the NHS Executive s Controls Assurance programme and the Clinical Negligence Scheme for Trusts (CNST). All of us are expected to become familiar with these standards as they relate to our work and further details are available from your manager. One of the controls assurance standards relates to Health & Safety. Under the Health & Safety at Work Act 1974, all of us have a duty: to take reasonable care of ourselves and others at work to co-operate in meeting the requirements of the law Further details are available from the Trust s Health & Safety Advisers. Infection Control It is now a requirement of the Department of Health that you accept personal responsibility for compliance with infection control policies and procedures at any time when you are working in clinical areas. Disclosure and Barring Service (DBS) check This offer of employment is subject to receipt by the Trust of a satisfactory DBS check. Trust Mission And Values The Values and Behaviours that are both displayed and aspired to at the Royal Surrey are: We work together to serve our community by: Delivering safe and excellent clinical care

12 Treating others with compassion and respect Driving improvement and efficiency The behaviours are defined below as: Delivering safe and excellent clinical care I share information openly and effectively with patients, staff and relatives I consider safety in my everyday actions and seek to minimise patient and staff harm I work to prevent and control infection I strive to deliver excellent outcomes Treating others with compassion and respect I treat others as I would like to be treated I am compassionate and empathetic I treat other people with dignity and respect I am courteous and polite I anticipate the needs of the people I serve I strive to make time Driving improvement and efficiency I provide support and challenge I continuously seek to improve service quality and share best practice I listen and act on suggestions for change I work resourcefully to deliver improved outcomes I use resources wisely I am passionate to deliver results Visiting arrangements If you wish to visit the Trust then please contact: Dr Izhar Bagwan, Specialty Lead for Histopathology at Royal Surrey Hospital via ext 4257 Or Dr Behdad Shambayati, Specialty Lead for Cytopathology at St Peter s Hospital via

13 PERSON SPECIFICATION Post: Consultant Histo / Cytopathologist Qualification ESSENTIAL FRCPath or equivalent Full and specialist registration (and a licence to practise) with the General Medical Council (GMC) (or eligible for registration within six months of interview) Holder of Certificate of Completion of Training (CCT), or within six months of award of CCT or equivalent by date of interview DESIRABLE Additional postgraduate qualification such as MD or PhD Evidence of publications Management Training Teaching/Education Qualification General Experience Evidence of thorough training in histo and cyto pathology. Participation in appropriate EQA schemes. Ability to take local/ regional leadership in a special area. Special expertise in one or more areas of pathology and willingness to take part in specialty reporting system. Excellent communication skills written and verbal An understanding of and ability to demonstrate your ability to: Empower others Lead through change Influence strategically Collaborative working Drive for improvement Integrity Highly developed IT skills Research and Training Experience of and willingness to participate in teaching at Active participation in appropriate professional

14 Personal skills pathologist and BMS level. Knowledge of principles of Clinical Supervision and Educational Supervision Evidence of experience of / commitment to audit and improving clinical practice/service development Experience and interest in undergraduate and postgraduate teaching Ability to communicate effectively with clinical, scientific, technical and administrative staff including a requirement for a good knowledge of, and ability to use, spoken and written English. bodies. Intention to develop or continue a research interest. Capacity to motivate, delegate and lead Flexibility and willingness to participate in and contribute to team working and service delivery.