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Job Description

Trust

• North Bristol NHS Trust

Locations

• The postholder will be based in the Department of Neuropathology at Frenchay Hospital (North Bristol NHS Trust.

 Location and Population

Frenchay Hospital is part of North Bristol NHS Trust - the largest Trust in the South and West Region and one of the largest in the country. It serves a local population of approximately 500,000 but also provides several specialist Regional services, including those in the Regional Neurosciences Centre. The Neuropathology Department at Frenchay Hospital is part of the Regional Neurosciences Centre, which  has an excellent national and international  reputation and provides neurological, neurosurgical and neuropsychiatric care to approximately 2.5 million people in the former Avon area, Gloucestershire, Somerset, Wiltshire and in some cases, further afield.

The two major hospitals within the Trust, Southmead and Frenchay Hospitals, are located approximately 4 miles apart. Both occupy large sites with a mixture of old and new buildings. In 2005 plans were agreed that wil bring the serives currently provided on two main sites, including the Department of  Neuropathology onto one site (Southmead Hospital) by about 2014.

Number of Beds and Specialities

The Trust has 1,300 in-patient beds. The Regional services it provides in addition to those in the clinical neurosciences are in plastic surgery, renal services and some orthopaedic services. The Trust also delivers acute inpatient and outpatient care in general medicine and surgery, obstetrics and gynaecology, paediatrics, urology, vascular surgery, breast surgery, endocrinology, respiratory medicine, gastroenterology, rheumatology, cardiology, palliative medicine and geriatric medicine.

University Links

The North Bristol NHS Trust hospitals are Teaching Hospitals. Both Frenchay and Southmead Hospitals host Clinical Academies in which University of Bristol medical students are taught in years 3, 4 and 5. The Department of Neuropathology has a strong academic bias and is part of the University of Bristol Institute of Clinical Neurosciences (ICN), in the School of Clinical Sciences.   Neuropathology contributed to the last RAE return in Psychiatry, Neuroscience, Psychology (UOA9) in which over 50% of the research work assessed was classified as 'world leading' or 'internationally excellent'.  The main research groups within the ICN are housed in well-equipped purpose-built laboratories. On the Frenchay site these comprise the Dementia Research Group laboratories and the Burden Centre laboratories. The South West Dementia Brain Bank is housed within the Dementia Research Group laboratories. Both laboratory complexes are equipped with a range of modern equipment including that for cell culture, protein and nucleic acid analysis, enzyme assays, immunofluorescence and confocal laser scanning microscopy. Clinical academic staff account for two of the 3 consultant posts in Neuropathology. All of the consultants have undergraduate teaching commitments, especially to medical students in years 2 and 5.

Postgraduate Education Facilities

There are excellent library and IT facilities. The Neuropathology Department has an extensive range of the major current general pathology and neuropathology texts and several major journals. There are seminar rooms in the Neuroscience Directorate and Postgraduate Centre with a variety of projection facilities including video microscopy and a digital data projection system.

Library Facilities

The Postgraduate Medical Education Centre at Frenchay Hospital houses a well-stocked medical library, with computer terminals offering access to databases such as Medline and Embase and full-text access to many journals. The Institute of Clinical Neurosciences Library, also at Frenchay Hospital, subscribes to a wide range of clinical neuroscience journals and it too has computer terminals that allow access to a wide range of other journals. As noted above, the Neuropathology Department has an excellent collection of reference books and journals.

Pathology Departments

The Trust Department of Pathology is based on the Southmead site, and  has a separate management structure and is part of a different Directorate (Clinical Support) from the Department of Neuropathology (which is part of the Neurosciences Directorate) . Mortuary facilities for Bristol, including North Bristol NHS Trust, are provided by the recently-built, well-equipped public mortuary at Flax Bourton, adjacent to the Coroner's Court, on the outskirts of the city. The mortuary includes 7 autopsy tables, of which one is in a separate suite for forensic and high-risk autopsies (the latter including cases of suspected Creutzfeldt-Jakob disease). The morturary is licensed by the Human Tissue Authority. The licence holder is Bristol City Council and the designated individual Mr Andrew Heryet, Department of Cellular Pathology, North Bristol NHS Trust.

Accreditation Status

The Department of Neuropathology has conditional CPA accreditation.

Personnel

Consultants
The Department is currently staffed by 3 consultants, each of whom has a 0.5 wte clinical service commitment in Neuropathology.

University staff (with Honorary Consultant posts)
Professor Seth Love
Dr Nicki Cohen

Trust staff
Dr Kathreena Kurian

Other career medical staff
None

Senior Scientific Staff
None

Specialist Nurses
None

Trainees
1 StR (this post)

Biomedical Scientists and technical aides, etc

Administrative and Clerical Staff
The Department has 1.3 wte A&C3 staff, (including 0.2 wte supported by research funds).

Departmental Workload

Managerial Structure

The Chief Executive of North Bristol NHS Trust is Ruth Brunt and the Medical Director is Dr Christopher Burton. The Clinical Director of Neuroscience is Dr Peter Heywood (Neurology). Professor Love is Head of Service for Neuropathology.

Liaison with Major Clinical Units

Current regular clinical and multidisciplinary team meetings are as follows: neurosurgery (including all tumour biopsies) – weekly; base-of-skull tumours (biweekly); paediatric neuro-oncology meeting – biweekly; clinical neuroscience meetings – weekly (including a monthly neuropathology demonstration); paediatric neuro-oncology – biweekly; muscle and nerve pathology bimonthly.

Tertiary Referral

The Neuroscience Centre at Frenchay Hospital is a tertiary referral centre for Neurosurgery, Neurology, Neuropsychiatry and Neuropathology.

Direct Clinical Responsibilities

Professor Love and Dr Cohen share responsibility for performing muscle and nerve biopsies on referred patients. These account for approximately half of muscle and nerve biopsies examined in the Department. The biopsies are usually performed under general anaesthesia in the neurosurgical theatres at Frenchay Hospital. The Specialist Trainee in Neuropathology will receive appropriate supervision and training in these procedures, including the consenting of patients, the surgical techniques and the post-operative management.

Laboratory Standing Operating Procedures (SOPs)

There are SOPs describing all the major aspects of laboratory organisation, operating equipment, special stains and technical procedures.

Health and Safety

The Department has implemented strict health and safety protocols. A health and safety manual is available in the main laboratory and is also accessible from any of the computer terminals in the Department. All specialist registrars are expected to be familiar with and to obey these procedures. Regular fire drills are performed.

Education and Training Programme

Education Supervisor: The educational supervisor is Professor Seth Love.

Induction: The new Specialist Trainee will be given a conducted tour of the Department and introduced to consultant medical staff, BMSs and secretarial staff. He/she will be made aware of health and safety procedures, of appropriate documentation covering all of the important protocols for reporting, handling specimens, key contact telephone numbers, etc. He/she will also complete a 2-day induction course run by the Trust and will be issued with an identity badge.

Accommodation and Equipment: The StR will have a dedicated office, with access to a microscope for dedicated personal use, and a computer with internet and email facilities. The StR's office includes a triple-header microscope that is used for teaching and for review and sign-out of cases. A digital dictation handset will be provided and there are adequate computer facilities in other locations in the Department. The Department has a Philips transmission electron microscope that has a digital imaging system and is used for examination of most muscle and nerve biopsies.

Appraisals: The Education Supervisor will perform regular appraisals of the StR during the course of the year. There will also be an interview with the ARCP panel on an annual basis.

Timetable of Education Events: There are regular CPCs and other medical meetings that the trainee is encouraged to attend. The StR will be expected to attend most MDTs and weekly clinical neuroscience and local-area pathology meetings, to present regularly at meetings and to liaiseclosely with the appropriate clinicians. There are regular teaching sessions he/she will be expected to attend.

Principal Service Responsibilities

Clinical Service Routine: The training program will be arranged to suit the experience and educational requirements of the specific trainee. The trainee will participate in cut-up, report neurosurgical biopsy histology, muscle and nerve biopsy histology and electron microscopy and CSF cytology specimens, and undertake post-mortem examinations, brain cuts and post-mortem histological examination under the supervision of each consultant on a rotational basis . One day per week will be allocated for research activities, audit and study. Blocks of time for secondment to other departments for specialist training, eg, in Paediatric Pathology, will be arranged as required.

The Department receives regular referrals of brains from local Home Office pathologists and there will be ample opportunity to gain forensic experience.

Clinical on-call commitments: There is currently no on-call commitment.

Objectives and Targets: The trainee is expected to keep a log of the approximate number and types of specimens he/she reports. This information should be available from the annual computer survey. Similarly, he/she should keep a record of the number of post-mortem examinations performed along with copies of the reports. This forms part of the basis of the training portfolio. It is expected that the trainee should be reporting approximately 400-500 biopsies per year (including at least 50 muscle and nerve biopsies, with electron microscopy), 300-400 CSF cytology specimens, and 40-50 macroscopic brain examinations with associated histology, the number of unsupervised reports depending on the experience gained.

Teaching Responsibilities

The Specialist Trainee may occasionally be asked to participate in teaching of medical students (particularly in tutorials to year 5 students), junior medical and nursing staff.

Research Possibilities

The Specialist Trainee will be encouraged to develop research skills and experience. If the Trainee has a particular interest in academic work, he/she will be able to take time out of the training programme to work for a higher degree. The trainee will be encouraged to present the results of his/her project/research at local (Trust) and national (e.g. British Neuropathological Society) meetings. Study leave will be granted and a budget is available for travel expenses. By the end of five years, the trainee should aim to have at least two substantive research papers published in peer-reviewed journals.

Clinical Audit

The Department encourages all staff to participate in clinical audit. All trainees are expected to complete and present at least one audit project per year.

Management Training

Management topics are included in the Regional Histopathology teaching programme. Attendance at external Management Courses is also encouraged towards the end of the training period. The StR will be encouraged to attend the bimonthly departmental business meetings.