haematology clinical fellow (international training fellow

Haematology Clinical Fellow

(International Training Fellow)

Job description

Date 11115 Context

Barts Health NHS Trust is one of Britainrsquos leading healthcare providers and the largest trust in the NHS It was created on 1 April 2012 by bringing together three trusts Barts and The London NHS Trust Newham University Hospital NHS Trust and Whipps Cross University Hospital NHS Trust The new trust has a turnover of approximately pound11 billion and approximately 15000 employees Together our hospitals - Newham University Hospital in Plaistow St Bartholomewrsquos (Barts) in the City The Royal London in Whitechapel and Whipps Cross in Leytonstone - deliver high quality clinical care to the people of east London and further afield The hospitals offer a full portfolio of services that serve the needs of the local community and are home to some of Britainrsquos leading specialist centres including cancer cardiac trauma and emergency care Barts Health also has one of the UKrsquos busiest childrenrsquos hospitals and internationally renowned surgical facilities Our vision is to create a world-class health organisation that builds on strong relations with our partners and the communities we serve ndash one dedicated to ending the historic health inequalities in east London We will build an international reputation for excellence in patient care research and education And as members of UCLPartners the largest academic health sciences system in the world we will ensure that our patients are some of the first in the country to benefit from the latest drugs and treatments We are looking for the best talent to lead our ambitious new healthcare organisation In return the Barts Health will provide unsurpassed professional development opportunities enabling investment in a range of new initiatives that would mean

bull doctors and nurses in training will be able to gain experience in different hospitals along the whole patient pathway

bull there would be greater opportunity for career progression ndash we could retain good staff who might otherwise leave to gain promotion

bull becoming world-class will enable us to recruit some of the best doctors and researchers in the world ndash who can share their knowledge and experience

bull joining forces with other partners in an Academic Health Science System will mean that staff would be better able to secure funds and pool their talents to develop new technology techniques and treatments

Job description

Job title Haematology Clinical Fellow (International Training Fellow)

Clinical academic group CSS Clinical Haematology

Boardcorporate function

Salary band Variable depending on seniority ST3 ndash ST7

Responsible to Dr Tom Butler (Clinical and Educational Supervisor)

Accountable to Associate Clinical Director

Hours per week State total hours a week the role requires

40

Location Royal London Hospital

Budgetary responsibility

Nil

Manages Direct reports NA

Indirect reports

Aim of the role

This position has been developed to provide training in laboratory haematology and an introduction to the NHS

Subsequent posts and job descriptions will be mapped to the educational needs of the post holder but will be within Barts Health Potential posts include Haemophilia Haemoglobinopathy Haemato-Oncology Paediatric Haematology General Haematology

Support other SpRs with laboratory and outpatient workload where necessary

Key working relationships

Healthcare Scientific staff Clinical Haematology Consultants Other SpRs at RLH SBH WXH and NUH sites Local GPs CNS and Day Unit teams Ward teams ndash FY1FY2CMT nursing and allied professionals Departmental managerial clerical and secretarial staff Pharmacy Radiology

Key result areas This Clinical Haematology post focuses on non-malignant laboratory haematology situated within the Barts Health Clinical Haematology amp Blood Sciences departments Trainees rotating to this post will spend 3-4 months in this position Educational focus on haematological diagnostics and initial contact with haematology patients in the context of the NHS

Main duties and responsibilities Activities at RLH site unless otherwise specified

Mon Tues Wed Thurs Fri

0900 Handover meeting Day Unit Lab work 1245 Haemophilia Lab meeting

Lab work 1130 Blood film training

0800 SpR teaching 0900 Haematology OP clinic

1000 Thrombosis lab meeting 1130 Lab Shout

0900 Diagnostics Teaching Lab work 1100 Immunophenotyping meeting

1400 Red cell lab meeting 1500 Immunophenotyping meeting 1600 Paediatric diagnostics meeting

Lab work 1500 Immunophenotyping meeting

Lab work 1400 Hospital Transfusion Team (monthly) 1500 Immunophenotyping meeting


Lab work Haematology executive (monthly)

The role is clinically supervised by the SIHMDS Consultant and the relevant Clinical Haematology Consultants in clinics and laboratory

Learning opportunities

Professional amp clinical responsibilities The below to be used as template for initial Clinical Supervision appraisal meeting and used as evidence of achievement

Gain experience in reporting blood films in an organised and thorough manner

Responsible for the routine daily reporting of adult blood films with consultant supervision Gain ability to produce an interim report for bone marrows at a competent level

Learn about the diagnostic side of haematology-including red cell haemostasis transfusion SIHMDS

Attendance at scheduled laboratory meetings Gain knowledge of variety of diagnostic methods

Learn about managing pts with a variety of haematological conditions Seeing patients in clinic

Learn about the organisation and management of a diagnostic laboratory

Expected to complete a quality improvement project andor audit and engage in laboratory management and quality Attendance at lab management meetings and hospital transfusion committees

Other Learn about some of the rarer disorders Go through the teaching slides Achieve expected competencies for level of training with assessments on e-portfolio courses Join BSH if applicable Exam revision if applicable Use BloodmedASH education programme websites Read journals BJHaem Blood NEJM Haematologica and guidelines Publications case reports images in haematology posters papers Teaching undergraduates and SHOs OSCE examiner Departmental teaching programmes seminars regional study days

Management and Leadership Additional experience available appropriate to stage of training

Information management Information technologypresentation skills Trial data collection and entry GCP training LIMS (Winpath) EPR (CRS) clinical coding

Key Competencies o Outpatient general haematology advice o Diagnostic methods and the classification of haematological disorders o Educational skills o Leadership skills

The job description is not intended to be exhaustive and it is likely that duties may be altered

from time to time in the light of changing circumstances and after consultation with the postholder

The post holder might be required to work across the Trust at any time throughout the duration of hisher contract which may entail travel and working at different hospital

Effort skills and working conditions Physical skills

Nil above those for working in clinical environment Manual handling training required

Physical effort


Mental effort Appropriate for stage of Specialist Training for competent practitioner Difficulties are flagged up through Clinical supervisors Educational supervisors and regional ARCP process Support can be provided on a case by case basis

Emotional effort

Appropriate for stage of Specialist Training for competent practitioner Haemato-oncology can be stressful due to managing critically ill patients with cancer at all stages from diagnosis to terminal care Difficulties are flagged up through Clinical supervisors Educational supervisors and regional ARCP process Support can be provided on a case by case basis

Working conditions

Standard Health and Safety and infection control policies are in place Mandatory training required where relevant

Performance management and appraisal

All staff are expected to participate in individual performance management process and reviews Appraisal and goal setting meeting with clinical supervisor required within 1st 2 weeks of commencement Ongoing use of e-portfolio to evidence curriculum and evolution of Personal Development Plan End appraisal and sign-off at end of post 2 work place based assessments completed satisfactorily (CBDmini-CEXDOPS) as a minimum

Personal development and training

Barts Health NHS Trust actively encourages development within the workforce and employees are required to comply with trust mandatory training Barts Healthrsquos education academy aims to support high quality training to NHS staff through various services The trust is committed to offering learning and development opportunities for all full-time and part-time employees No matter where you start within the NHS you will have access to extra training and be given every chance to progress within the organisation You will receive an annual personal review and development plan to support your career progression and you will be encouraged to develop your skills and experience

Health and safety at work

The postholder has a duty of care and personal obligation to act to reduce healthcare-associated infections (HCAIs) They must attend mandatory training in infection prevention and control (IPampC) and be compliant with all measures required by the trust to reduce HCAIs All post holders must comply with trust infection screening and immunisation policies as well as be familiar with the trusts IPampC policies including those that apply to their duties such as hand decontamination personal protective equipment aseptic techniques and safe disposal of sharps All staff must challenge noncompliance with infection prevention and control policies immediately and feedback through the appropriate line managers if required

Confidentiality and data protection

All employees are expected to comply with all trust policies and procedures related to confidentiality and data protection and to work in accordance of the Data Protection Act 1998 For those posts where there is management or supervision of other staff it is the responsibility of that employee to ensure that their staff receive appropriate training (eg HISS induction organising refresher sessions for staff when necessary)

Conflict of interest

The trust is responsible for ensuring that the service provided for patients in its care meets the highest standard Equally it is responsible for ensuring that staff do not abuse their official position for personal gain or to benefit their family or friends The trustrsquos standing orders require any officer to declare any interest direct or indirect with contracts involving the trust Staff are not allowed to further their private interests in the course of their NHS duties

Equality and diversity

The trust values equality and diversity in employment and in the services we provide It is committed to promoting equality and diversity in employment and will keep under review our policies and procedures to ensure that the job related needs of all staff working in the Trust are recognised The Trust will aim to ensure that all job applicants employees or clients are treated fairly and valued equally regardless of sex marital status domestic circumstances age race colour disablement ethnic or national origin social background or employment status sexual orientation religion beliefs HIV status gender reassignment political affiliation or trade union membership Selection for training and development and promotion will be on the basis of the individualrsquos ability to meet the requirements for the job You are responsible for ensuring that the trustrsquos policies procedures and obligation in respect of promoting equality and diversity are adhered to in relation to both staff and services

NHS managersrsquo code of conduct

As an NHS manager you are expected to follow the code of conduct for NHS managers (October 2002) wwwnmc-ukorg

Safeguarding adults and children

Employees must be aware of the responsibilities placed on them to maintain the wellbeing and protection of vulnerable children and adults If employees have reason for concern that a patient is at risk they should escalate this to an appropriate person ie line manager safeguarding childrens lead matron ward sisterchange nurse site manager consultant

Budgetary management

If you have responsibility for a budget you are expected to operate within this and under the trustrsquos standing financial instructions (available in the intranetrsquos policies section) at all times

Barts Health values based leadership

Our leaders ensure a focus on health where patients are at the centre of all we do They work to create a culture where innovation is promoted and encouraged They lead by example and demonstrate value based decision making as being integral to the ways of working within the Trust Barts Health leaders are role models who demonstrate those attitudes and behaviours which will make us unique Our leaders are passionate about delivering high quality patient care take pride in the work that they do to and are committed to the delivering the Barts Health NHS Trust 10 pledges of 1 Patients will be at the heart of all we do 2 We will provide consistently high quality health care 3 We will continuously improve patient safety standards 4 We will sustain and develop excellence in research development and innovation 5 We will sustain and develop excellence in education and training 6 We will promote human rights and equalities 7 We will work with health partners to improve health and reduce health inequalities 8 We will work with social care partners to provide care for those who are most vulnerable 9 We will make the best use of public resources 10 We will provide and support the leadership to achieve these pledges Our leaders are visible leaders who believe in spending time listening and talking our staff patients and partners about the things that are important to them and the changes they would like to make to continuously improve patient care Barts Health leaders work with their teams to develop organisational values embed them in our ways of working and create the cultural changes required to ensure that we consistently provide an excellent patient experience regardless of the point of delivery in an environment where people want to work regardless of where they work or what they do

Person specification

Essential = E Desirable = D

E or D

Application form

Interview

Qualifications and knowledge

MBBS or equivalent MRCP Part 1 or MRCPCH Part 1 A and B Full MRCP (UK) Intercalated BSc or equivalent Higher degree MSc PhD MD

E D D D D

radic radic radic radic radic

Experience Demonstrates awareness of the basics of managing patients with haematological disease Competence at core-completion level in the management of medical emergencies in-patients and outpatients Evidence of skills in the management of acute medical emergencies (eg ALERT IMPACT certification) Evidence of skills in the management of patients not requiring hospital admission Evidence of ST3-level procedural skills relevant to medical patients (clinical independence in central venous cannulation chest drain insertion joint aspiration DC cardioversion abdominal paracentesis)

E D D D D


radic radic

Evidence that present achievement and performance is commensurate with totality of training Evidence of experience in a range of acute medical specialties with experience of managing patients on unselected medical take during core training or equivalent Experience at CTST 12-level of managing patients with haematological disease and managing haematological emergencies by the time of commencement of ST3 training

E D D

radic radic radic

Post Specialist Trainee Haematology

ST3 equivalent

Band To be confirmed

Deptward PathologyClinical Haematology


E or D

Application form

Interview

Skills Capacity to manageprioritise time and information effectively Capacity to operate under pressure Demonstrates understanding of research including awareness of ethical issues Demonstrates understanding of the basic principles of audit clinical risk management evidence-based practice patient safety and clinical quality improvement initiatives Evidence of teaching experience andor training in teaching Demonstrates an understanding of research methodology Evidence of relevant academic publications Evidence of involvement in an audit project a quality improvement project formal research project or other activity which focuses on patient safety and clinical improvement Demonstrates an interest in and commitment to the specialty beyond the mandatory curriculum Demonstrates an understanding of clinical governance

E E E E E D D D D D

radic radic radic radic radic radic radic radic radic

radic radic radic radic radic radic radic radic radic radic

Personal and people development

Shows initiativedriveenthusiasm (self-starter motivated shows curiosity initiative) Demonstrable interest in and understanding of the specialty Commitment to personal and professional development Extracurricular activitiesachievements relevant to the specialty Evidence of participation at meetings and activities relevant to the specialty

E E E D D

radic radic radic radic


Communication Demonstrates clarity in writtenspoken communication Able to work in multi-professional teams and supervise junior medical staff Ability to show leadership make decisions organise and motivate other team members for the benefit of patients through for example audit and quality improvement projects

E E E

radic radic radic

radic radic radic

Specific requirements

On call from home Sufficient to perform the duties of the post with any aids and adaptations

E E

radic

radic

MLS 22514

Educational resources

WHO Classification of tumours of haematopoietic and lymphoid tissues (2008) IARC

Leukaemia diagnosis Bain B Blackwell

Postgraduate Haematology Hofbrand V Catovsky D Tuddenham E Blackwell

Molecular Haematology Provan D Gribben J Blackwell

Hematopathology Naeim Rao and Grody (2008) Academic Press

ASH Educational Books httpasheducationbookhematologylibraryorg

Marcucci G Haferlach T Doumlhner H Molecular genetics of adult acute myeloid leukemia prognostic and therapeutic implications J Clin Oncol 2011 Feb 1029(5)475-86

Smith ML Hills RK Grimwade D Independent prognostic variables in acute myeloid leukaemia Blood Rev 2011 Jan25(1)39-51

David Grimwade et al Refinement of cytogenetic classification in acute myeloid leukemia determination of prognostic significance of rare recurring chromosomal abnormalities among 5876 younger adult patients treated in the United Kingdom Medical Research Council trials Blood 2010 116354-365

Grimwade D Vyas P Freeman S Assessment of minimal residual disease in acute myeloid leukemia Curr Opin Oncol 2010 Nov22(6)656-63

Hartmut Doumlhner et al Diagnosis and management of acute myeloid leukemia in adults recommendations from an international expert panel on behalf of the European LeukemiaNet Blood 2010 115453-474

httpwwwnccnorgprofessionalsphysician_glsf_guidelinesasp - AML

httpwwwbcshguidelinescomdocumentsaml_bjh_2006pdf

Pui CH et al Biology risk stratification and therapy of pediatric acute leukemias an update J Clin Oncol 2011 Feb 1029(5)551-65

Rowe JM Prognostic factors in adult acute lymphoblastic leukaemia Br J Haematol 2010 Aug150(4)389-405

httpwwwbcshguidelinescomdocumentsMYELOMA_Mngmt_GUIDELINE_REVISION_Sept_2010pdf

httpwwwbcshguidelinescomdocumentsBCSH_MM_Supportive_Care_Guidelines__Sept_2010pdf

httpwwwbcshguidelinescomdocumentsMGUS_bjh_28092009pdf

httpwwwbcshguidelinescomdocumentssolitary_plamacytoma_bcsh_FINAL_190109pdf

httpwwwbcshguidelinescomdocumentswaldenstroms_151106pdf

httpwwwbcshguidelinescomdocumentsmyeloma_imaging_guidelines_2006pdf

Palumbo A Anderson K N Engl J Med 2011 Mar 17364(11)1046-60 Multiple myeloma

Dimopoulos M et al Blood 2011 May 5117(18)4701-4705 Consensus recommendations for standard investigative workup report of the International Myeloma Workshop Consensus Panel 3

Sawyer JR The prognostic significance of cytogenetics and molecular profiling in multiple myeloma Cancer Genet 2011 Jan204(1)3-12

Munshi NC et al Blood 2011 May 5117(18)4696-4700 Consensus recommendations for risk stratification in multiple myeloma report of the International Myeloma Workshop Consensus Panel 2

httpwwwbcshguidelinescomdocumentsALamyloidosis_bjh_2106_2004pdf

Goldman JM Semin Hematol 2010 Oct47(4)302-11 Chronic myeloid leukemia a historical perspective

Chen Y et al Protein Cell 2010 Feb1(2)124-32 Molecular and cellular bases of chronic myeloid leukemia

Hernaacutendez-Boluda JC et al Best Pract Res Clin Haematol 2009 Sep22(3)343-53 Prognostic factors in chronic myeloid leukaemia

Baccarani M et al Best Pract Res Clin Haematol 2009 Sep22(3)331-41 Response definitions and European Leukemianet Management recommendations

Branford S et al Semin Hematol 2010 Oct47(4)327-34 Practical considerations for monitoring patients with chronic myeloid leukemia

httpwwwbcshguidelinescomdocumentsCML_BCR-ABL_270707pdf

Bejar R et al J Clin Oncol 2011 Feb 1029(5)504-15 Unraveling the molecular pathophysiology of myelodysplastic syndromes

Issa JP Hematol Oncol Clin North Am 2010 Apr24(2)317-30 Epigenetic changes in the myelodysplastic syndrome

Barlow JL Cell Cycle 2010 Nov 19(21)4286-93 New insights into 5q- syndrome as a ribosomopathy

Koh Y et al Leuk Res 2010 Oct34(10)1344-50 Hypoplastic myelodysplastic syndrome (h-MDS) is a distinctive clinical entity with poorer prognosis and frequent karyotypic and FISH abnormalities compared to aplastic anemia (AA)

Bacher U et al Br J Haematol 2011 Mar 9 Recent advances in diagnosis molecular pathology and therapy of chronic myelomonocytic leukaemia

Cazzola M Hematol Oncol Clin North Am 2010 Apr24(2)459-68 Prognostic classification and risk assessment in myelodysplastic syndromes

Komrokji RS Hematol Oncol Clin North Am 2010 Apr24(2)443-57 Myelodysplastic syndromes classification and risk stratification Wadleigh M Tefferi A Int J Hematol 2010 Mar91(2)174-9 Classification and diagnosis of myeloproliferative neoplasms according to the 2008 World Health Organization criteria

Tefferi A Vainchenker W J Clin Oncol 2011 Feb 1029(5)573-82 Myeloproliferative neoplasms molecular pathophysiology essential clinical understanding and treatment strategies

Tefferi A Leukemia 2010 Jun24(6)1128-38 Novel mutations and their functional and clinical relevance in myeloproliferative neoplasms JAK2 MPL TET2 ASXL1 CBL IDH and IKZF1

httpwwwbcshguidelinescomdocumentspublished_thrombocytosis_bjh_042010pdf

httpwwwbcshguidelinescomdocumentspolycythaemia_amendment_07pdf

httpwwwbcshguidelinescomdocumentspolycythaemia_bjh_2005pdf

httpwwwbcshguidelinescomdocumentsanegralide_bcsh_2000pdf

httpwwwnccnorgprofessionalsphysician_glspdfnhlpdf

httpwwwbcshguidelinescomdocumentsnodal_NHL_bcsh_2003pdf

httpwwwbcshguidelinescomdocumentsLymphoma_diagnosis_bcsh_042010pdf

httpwwwbcshguidelinescomdocumentsLymphoma_disease_app_bcsh_042010pdf

Wilkins BS Pitfalls in lymphoma pathology avoiding errors in diagnosis of lymphoid tissues J Clin Pathol 201164(6)466-76

Campo E et al The 2008 WHO classification of lymphoid neoplasms and beyond evolving concepts and practical applications Blood 2011117(19)5019-32

Salaverria I Siebert R The gray zone between Burkitts lymphoma and diffuse large B-cell lymphoma from a genetics perspective J Clin Oncol 2011 May 1029(14)1835-43

Tomita N BCL2 and MYC Dual-Hit LymphomaLeukemiaJ Clin Exp Hematop 201151(1)7-12

Sweetenham JW Molecular signatures in the diagnosis and management of diffuse large B-cell lymphoma Curr Opin Hematol 2011 Jul18(4)288-92

de Jong D Balagueacute Ponz O The molecular background of aggressive B cell lymphomas as a basis for targeted therapy J Pathol 2010 Oct 14

Cortelazzo S Ponzoni M Ferreri AJ Dreyling M Mantle cell lymphoma Crit Rev Oncol Hematol 2011 Jun 7

httpwwwbcshguidelinescomdocumentsT-cell_guideline_final_bcshpdf

de Leval L et al Molecular classification of T-cell lymphomas Crit Rev Oncol Hematol 2009 Nov72(2)125-43

Ishida F Kwong YL Diagnosis and management of natural killer-cell malignancies Expert Rev Hematol 2010 Oct3(5)593-602

httpwwwnccnorgprofessionalsphysician_glspdfhodgkinspdf

Steidl C Connors JM Gascoyne RD Molecular pathogenesis of Hodgkins lymphoma increasing evidence of the importance of the microenvironment J Clin Oncol 2011 May 1029(14)1812-26

Josting A Prognostic factors in Hodgkin lymphoma Expert Rev Hematol 2010 Oct3(5)583-92


httpwwwbcshguidelinescomdocumentschronicLL_05052004pdf

httpwwwbcshguidelinescomdocumentsimmunophenotyping_2002pdf

Matutes E Attygalle A Wotherspoon A Catovsky D Diagnostic issues in chronic lymphocytic leukaemia (CLL) Best Pract Res Clin Haematol 2010 Mar23(1)3-20

Shanafelt TD Ghia P Lanasa MC Landgren O Rawstron ACMonoclonal B-cell lymphocytosis (MBL) biology natural history and clinical management Leukemia 2010 Mar24(3)512-20

Caporaso N et al Chronic lymphocytic leukaemia genetics overview Br J Haematol 2007 Dec139(5)630-4

Zenz T Mertens D Doumlhner H Stilgenbauer Importance of genetics in chronic lymphocytic leukemia Blood Rev 2011 May25(3)131-7

Lanasa MC Novel insights into the biology of CLL Hematology Am Soc Hematol Educ Program 2010201070-6

Pekarsky Y Zanesi N Croce CM Molecular basis of CLL Semin Cancer Biol 2010 Dec20(6)370-6

Zenz T Froumlhling S Mertens D Doumlhner H Stilgenbauer S Moving from prognostic to predictive factors in chronic lymphocytic leukaemia (CLL) Best Pract Res Clin Haematol 2010 Mar23(1)71-84

Hallek M et al Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute-Working Group 1996 guidelines Blood 2008 Jun 15111(12)5446-56

Dungarwalla M Matutes E Dearden CE Prolymphocytic leukaemia of B- and T-cell subtype a state-of-the-art paper Eur J Haematol 2008 Jun80(6)469-76

Ravandi F et al Mature T-cell leukemias Cancer 2005 Nov 1104(9)1808-18

Dearden CE T-cell prolymphocytic leukemia Clin Lymphoma Myeloma 20099 Suppl 3S239-43

Dearden C Large granular lymphocytic leukaemia pathogenesis and management Br J Haematol 2011 Feb152(3)273-83

httpwwwbcshguidelinescomdocumentshairy_cell_leukaemia_2000pdf

WikiFlow httpwikiclinicalflowcom

httpatlasgeneticsoncologyorgAnomaliesAnomlistehtml

HMDS httpwwwhmdsorguk

httpimagebankhematologyorg

httpimagebloodlinenet

Curriculum

A B C D E F G H

H1 Introduction to Laboratory Haematology - sufficient understanding of lab haem to advise on the interpretation of results under supervision

Knowledge Gain basic knowledge of laboratory practice including laboratory management organisation health and safety and quality control x x X X Be familiar with the routine and out of hours service provision of the laboratory X Explain the principles behind and appropriate use of automated blood counters including factors interfering with results x X X Outline making and staining of peripheral blood films and setting up and use of the light microscope x x X X Describe the use of different cytochemical stains x X X Outline basic Blood Transfusion techniques (manual and automated) including blood group testing antibody screening and cross-matching understanding their principles and limitations

x X X

Describe the techniques for coagulation testing including automation of coagulation tests and thrombophilia tests ndash understanding their principles and limitations

x X X

Understands the tests used in the diagnosis of haemoglobinopathies x X X Skills Works safely in the laboratory X Interprets results generated from automated cell counters x x X X Analyses and interprets blood films and differential white cell count x x X X Recognises malignant haematological disorders red cell abnormalities amp malarial parasites x x x X X Performs bone marrow aspiration and trephine biopsy with supervision Prepares slides and trephine roll preparations x X X Interprets results of blood grouping cross matching direct antiglobulin test and recognises clinically significant antibodies x X X Interprets results of PT INR APTT Thrombin time Fibrinogen assay and Fibrin D-dimer results x X X Interprets thrombophilia testing results x X X Recognises in the laboratory and advises on the initial management of common anaemias acute and chronic leukaemia myeloma and lymphomas

x x x x X X

Behaviours Recognises the importance of working with the laboratory staff and exhibits rapport with them X Participates in liaison between laboratory and clinical staff x x x X Applies laboratory results to patient care

x x x X X

H2 Laboratory Haematology - To be competent in the practice of laboratory haematology

Knowledge Describes normal and abnormal peripheral blood film appearances x x X X Describe the indications for and technique of performing bone marrow aspirate and trephine biopsies x x x x X X Define the indications for use and understands the results of specific cytochemical stains immunophenotyping cytogenetics and molecular investigations as applied to blood and bone marrow samples

x x x x x x x

Describe the laboratory investigation of haemolytic disorders including disorders of the red cell membrane enzyme disorders microangiopathic and immune haemolysis

x x X X

Describe the appearances of haematological malignancies in the CSF x x X X Explain the principles use and limitations of Point-of-Care testing x X X Explain the principles of laboratory management x X X

Skills Identifies and reports normal and abnormal peripheral blood films including those flagged as abnormal by BMS (biomedical scientists) or automated counter

x x X X

Accurately reports red cell white cell and platelet abnormalities on blood films Recognises malarial parasites on blood films and other parasites on blood filmsbone marrow aspirates

x X X X

Performs bone marrow aspiration and trephine biopsy including preparation of slides and trephine rolls x X X X Recognises and reports presence of malignant haematological cells in CSF x X X X

Interprets results of investigations for haemolytic disorders X X X

Demonstrates familiarity with laboratory quality management including internal and external quality control EQA schemes commercially available laboratory computer systems staff performance management and appraisals

X x X X

Participates in the routine and out of hours provision of haematology management and advice x X

Behaviours Relates laboratory findings to the clinical picture and applies them to patient care x x x X X Consults where necessary to obtain appropriate advice in reporting findings x X Communicates effectively with patients GPs and other clinicians regarding abnormal laboratory results needing further investigation x x x X Establishes rapport and understanding with laboratory staff X

A B C D E F G H I

A ndash Clinical ward experience B - Outpatient clinics C ndash Lab meetings D - Internal teaching programmes seminars regional study days formal external courses E - QM programme and SOPs F - Departmental meetings G ndash Diagnostics (Exposure to morphology flow cytogenetics and molecular haematology Flow cytometry meeting Laboratory experience H - Self directed learning

History Taking

To develop the ability to elicit a relevant focused history from patients with increasingly complex issues and in increasingly challenging circumstances

To record the history accurately and synthesise this with relevant clinical examination establish a problem list increasingly based on pattern recognition including differential diagnosis(es) and formulate a management plan that takes account of likely clinical evolution

To develop the ability to prioritise the patientrsquos agenda encompassing their beliefs concerns expectations and needs

Clinical Examination

To develop the ability to perform focused relevant and accurate clinical examination in patients with increasingly complex issues and in increasingly challenging circumstances

To relate physical findings to history in order to establish diagnosis(es) and formulate a management plan

Therapeutics and Safe Prescribing

To develop your ability to prescribe review and monitor appropriate therapeutic interventions relevant to clinical practice including non-medication-based therapeutic and preventative indications

Clinical Reasoning Time Management and Decision Making

To develop the ability to formulate a diagnostic and therapeutic plan for a patient according to the clinical information available

To be able to communicate a diagnostic and therapeutic plan appropriately

To demonstrate increasing ability to prioritise and organise clinical and clerical duties in order to optimise patient care

To demonstrate improving ability to make appropriate clinical and clerical decisions in order to optimise the effectiveness of the clinical team resource

Safety in Clinical Practice

To understand that patient safety depends on the effective and efficient organisation of care and health care staff working well together

To understand that patient safety depends on safe systems not just individual competency and safe practice

To never compromise patient safety

To understand the risks of treatments and to discuss these honestly and openly with patients so that patients are able to make decisions about risks and treatment options

To ensure that all staff are aware of risks and work together to minimise risk

To develop the ability to work well in a variety of different teams and team settings ndash for example the ward team and the infection control team ndash and to contribute to discussion on the teamrsquos role in patient safety

To develop the leadership skills necessary to lead teams so that they are more effective and better able to deliver safer care

Contributes to multidisciplinary team-working

To recognise the desirability of monitoring performance learning from mistakes and adopting no blame culture in order to ensure high standards of care and optimise patient safety

To develop the ability to manage and control infection in patients including controlling the risk of cross-infection appropriately managing infection in individual patients and working appropriately within the wider community to manage the risk posed by communicable diseases

To recognise the causes of error and to learn from them to realise the importance of honesty and effective apology and to take a leadership role in the handling of complaints

Communication

To recognise the need and develop the abilities to communicate effectively and sensitively with patients relatives and carers

Demonstrates an ability to break bad news clearly and empathically including the communication of a terminal prognosis

To recognise the fundamental importance of breaking bad news

To develop strategies for skilled delivery of bad news according to the needs of individual patients and their relatives carers

To recognise and accept the responsibilities and role of the doctor in relation to other healthcare professionals

Communicates clearly with colleagues in primary and secondary care via clinic letters letters of referral and discharge documents

Recognises the importance of good communication in the practice of haematology

To pursue a holistic and long term approach to the planning and implementation of patient care in particular to identify and facilitate the patientrsquos role in their own care

Health Promotion and Public Health

To develop the ability to work with individuals and communities to reduce levels of ill health remove inequalities in healthcare provision and improve the general health of a community

Legal Framework for Practice

To know understand and apply appropriately the principles guidance and laws regarding medical ethics and confidentiality

To understand the necessity of obtaining valid consent from the patient and how to obtain it

To understand the legal framework within which healthcare is provided in the UK andor devolved administrations in order to ensure that personal clinical practice is always provided in line with this legal framework

Practices in accordance with legal principals Promotes and practices accurate documentation in clinical practice

Explain the role of clinical trials in haematology and describe research governance

To ensure that research is undertaken using relevant ethical guidelines

Recognises the role of research in medical advances promotes ethical research Evidence and Guidelines

Describe the principles of evidence based medicine and the role of guidelines

To develop the ability to make the optimal use of current best evidence in making decisions about the care of patients

To develop the ability to construct evidence based guidelines and protocols in relation to medical practise

Critically evaluates research data andor publications in scientific journals and applies conclusions into practice

Reviews and applies local and national guidelines

Keeps up to date with national reviews and guidelines of practice Audit

Describe the principles of clinical audit including the audit cycle

To develop the ability to perform an audit of clinical practice and to apply the findings appropriately and complete the audit cycle

Participates in audit

Recognises the benefit of audit to clinical care

Teaching and Training

Describe the principles underlying teaching and training

To develop the ability to teach to a variety of different audiences in a variety of different ways

To be able to assess the quality of the teaching

To be able to train a variety of different trainees in a variety of different ways

To be able to plan and deliver a training programme with appropriate assessments

Able to teach medical nursing scientific and other professions effectively

Advances own educational ability through continuous learning Personal Behaviour

To develop the behaviours that will enable the doctor to become a senior leader able to deal with complex situations and difficult behaviours and attitudes To work increasingly effectively with many teams and to be known to put the quality and safety of patient care as a prime objective

To develop the attributes of someone who is trusted to be able to manage complex human legal and ethical problem To become someone who is trusted and is known to act fairly in all situations

Management and NHS Structure

Outline the organisational structure of the NHS and role of haematologists as managers

To understand the structure of the NHS and the management of local healthcare systems in order to be able to participate fully in managing healthcare provision

Contributes to clinical and laboratory management meetings

Willing to improve managerial skills and engage in management of haematology services

Date 11115 Context

Barts Health NHS Trust is one of Britainrsquos leading healthcare providers and the largest trust in the NHS It was created on 1 April 2012 by bringing together three trusts Barts and The London NHS Trust Newham University Hospital NHS Trust and Whipps Cross University Hospital NHS Trust The new trust has a turnover of approximately pound11 billion and approximately 15000 employees Together our hospitals - Newham University Hospital in Plaistow St Bartholomewrsquos (Barts) in the City The Royal London in Whitechapel and Whipps Cross in Leytonstone - deliver high quality clinical care to the people of east London and further afield The hospitals offer a full portfolio of services that serve the needs of the local community and are home to some of Britainrsquos leading specialist centres including cancer cardiac trauma and emergency care Barts Health also has one of the UKrsquos busiest childrenrsquos hospitals and internationally renowned surgical facilities Our vision is to create a world-class health organisation that builds on strong relations with our partners and the communities we serve ndash one dedicated to ending the historic health inequalities in east London We will build an international reputation for excellence in patient care research and education And as members of UCLPartners the largest academic health sciences system in the world we will ensure that our patients are some of the first in the country to benefit from the latest drugs and treatments We are looking for the best talent to lead our ambitious new healthcare organisation In return the Barts Health will provide unsurpassed professional development opportunities enabling investment in a range of new initiatives that would mean

bull doctors and nurses in training will be able to gain experience in different hospitals along the whole patient pathway

bull there would be greater opportunity for career progression ndash we could retain good staff who might otherwise leave to gain promotion

bull becoming world-class will enable us to recruit some of the best doctors and researchers in the world ndash who can share their knowledge and experience

bull joining forces with other partners in an Academic Health Science System will mean that staff would be better able to secure funds and pool their talents to develop new technology techniques and treatments

Job description








40



Nil


Indirect reports

Aim of the role






































Physical effort



Emotional effort


Working conditions
























E or D

Application form

Interview



E D D D D



E D D D D


radic radic


E D D

radic radic radic


ST3 equivalent




E or D

Application form

Interview


E E E E E D D D D D





E E E D D




E E E

radic radic radic

radic radic radic



E E

radic

radic

MLS 22514





















































































Curriculum

A B C D E F G H



x X X


x X X


x x x x X X


x x x X X



x x x x x x x


x x X X



x x X X


x X X X




X x X X



A B C D E F G H I


History Taking


























Communication












































Job description








40



Nil


Indirect reports

Aim of the role






































Physical effort



Emotional effort


Working conditions
























E or D

Application form

Interview



E D D D D



E D D D D


radic radic


E D D

radic radic radic


ST3 equivalent




E or D

Application form

Interview


E E E E E D D D D D





E E E D D




E E E

radic radic radic

radic radic radic



E E

radic

radic

MLS 22514





















































































Curriculum

A B C D E F G H



x X X


x X X


x x x x X X


x x x X X



x x x x x x x


x x X X



x x X X


x X X X




X x X X



A B C D E F G H I


History Taking


























Communication











































































Physical effort



Emotional effort


Working conditions
























E or D

Application form

Interview



E D D D D



E D D D D


radic radic


E D D

radic radic radic


ST3 equivalent




E or D

Application form

Interview


E E E E E D D D D D





E E E D D




E E E

radic radic radic

radic radic radic



E E

radic

radic

MLS 22514





















































































Curriculum

A B C D E F G H



x X X


x X X


x x x x X X


x x x X X



x x x x x x x


x x X X



x x X X


x X X X




X x X X



A B C D E F G H I


History Taking


























Communication






























































E or D

Application form

Interview



E D D D D



E D D D D


radic radic


E D D

radic radic radic


ST3 equivalent




E or D

Application form

Interview


E E E E E D D D D D





E E E D D




E E E

radic radic radic

radic radic radic



E E

radic

radic

MLS 22514





















































































Curriculum

A B C D E F G H



x X X


x X X


x x x x X X


x x x X X



x x x x x x x


x x X X



x x X X


x X X X




X x X X



A B C D E F G H I


History Taking


























Communication













































E or D

Application form

Interview


E E E E E D D D D D





E E E D D




E E E

radic radic radic

radic radic radic



E E

radic

radic

MLS 22514





















































































Curriculum

A B C D E F G H



x X X


x X X


x x x x X X


x x x X X



x x x x x x x


x x X X



x x X X


x X X X




X x X X



A B C D E F G H I


History Taking


























Communication
































































































































Curriculum

A B C D E F G H



x X X


x X X


x x x x X X


x x x X X



x x x x x x x


x x X X



x x X X


x X X X




X x X X



A B C D E F G H I


History Taking


























Communication














































x x x x x x x


x x X X



x x X X


x X X X




X x X X



A B C D E F G H I


History Taking


























Communication













































History Taking


























Communication


















































Communication












































haematology clinical fellow (international training fellow

Documents