Consultant Haematologist (Haemostasis and Thrombosis)

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The post holder’s duties will be primarily at the Nuffield Orthopaedic Hospital however it is a condition of the appointment that the postholder will be willing to work in any of the Trust’s locations.

Clinical

The Oxford Haemophilia & Thrombosis Centre is one of the largest haemophilia comprehensive care centres in the country. The catchment area encompasses much of central southern England, including the counties of Oxfordshire, Berkshire, Buckinghamshire, Northamptonshire and Wiltshire.

The daily work of the department involves the routine clinical review and management of acute problems in adults with congenital bleeding disorders. Patients have 24/7 access to the care from OHTC and are regularly reviewed at the centre. There are no beds within the centre, which is a purely outpatient facility. Patients who require inpatient treatment are admitted to the haematology ward or the most appropriate ward or department within the Trust’s various sites. The majority of the in-patient haemostasis work covers the care of haemophilia patients who require support for surgical procedures or the care of patients with newly diagnosed acquired bleeding disorders.

The department has its own specialist haemostasis laboratory and each consultant has direct access to all facilities in the laboratory and will provide advice to clinicians about results from the laboratory. There are no specific laboratory facilities or equipment that are needed for the post-holder for this role.

The department is also responsible for the diagnosis and treatment of patients with deep vein thrombosis (DVT) referred by local general practitioners as well as supervision of the anticoagulation of patients within the county. A daily DVT diagnostic nurse-led service runs from OHTC and the consultant on-call will provide immediate oversight for any clinical concerns that arise. Patients found to have a DVT are reviewed by the junior doctor team at the centre. Thrombosis clinics are held regularly and each consultant will participate in these clinics.

The post-holder will join 4 other haemostasis consultants and share the routine work which includes weekly inherited bleeding disorder and thrombosis clinics and a new patient clinic. Other routine commitments specific to this post will include attending monthly haemostasis laboratory meetings, monthly research meetings and departmental meetings and quarterly governance meeting. There is a 1 in 5 on-call commitment during which the post-holder will provide specialist advice to clinicians at the Trust as well as regionally. An important part of the workload involves giving advice over the telephone to GP’s and other hospital doctors and this work is included in the on-call commitment.

Specifically, the post-holder will lead the haemophilia and inherited bleeding disorder service for the region as well as the regional haemostasis laboratory service for haemostasis and thrombosis. The post-holder will also lead and co-ordinate the MDT for complex inherited bleeding disorder patients across the region and will work closely with the regional haemophilia network and specialist haemophilia commissioners. The successful appointee will have a shared office at OHTC and secretarial and administrative support from within OHTC.

Teaching/Research

Oxford University Hospitals NHS Foundation Trust is a teaching hospital trust, and the post-holder will be required to participate in programmes for teaching clinical students, training junior doctors and in clinical examinations.  It is expected that this will be an integral part of everyday clinical activity. Specifically, the post-holder will take part in the formal, lecture-based, teaching of specialist registrars approximately once every 2 months; the teaching of 4^th year medical students in clinic – fortnightly for a 3 - 4 month block as well as an annual scheduled lecture on haemostasis/thrombosis and 4 small group teaching sessions. Daily routine discussion about patients will form an important informal teaching opportunity for the junior doctors at OHTC and is expected. The department of haematology, which includes OHTC, has been approved to train specialist registrars in haematology. The post-holder’s contribution to teaching, training and research will be included in the regular job plan review.  The department has been designated an International Haemophilia Training Centre (IHTC) by the World Federation of Haemophilia (WFH) and so health care professionals from overseas are also sent here for training from time to time. As the lead for haemophilia, the successful candidate will co-ordinate the training of overseas visitors with the WFH and IHTC.

The philosophy of OHTC is that every patient who attends should be considered for a research study. There is therefore an active research portfolio and the post-holder is expected to support the care of patients who are enrolled in clinical studies. This routine work is included in the job plan. There are opportunities for the post-holder to lead research, according to the post-holders own interests and this can be discussed within the department. OHTC is part of the department of haematology and is affiliated with the Oxford Centre for Haematology, Oxford University. As such, every haematology consultant is eligible for honorary member status of Oxford University, within the Radcliffe Department of Medicine. Most research conducted at present at OHTC is clinical research and is supported by the OUHFT research and development team. Primary research interests are encouraged and there is access to OHTC dedicated research laboratories. There is a shared OUHFT and Oxford University R&D service, which facilitates joined up working of the clinical and university services.

Clinical Governance

The post-holder will participate in all clinical governance activities, including clinical audit, clinical effectiveness, risk management, quality improvement activities as required by the Trust, and external accrediting bodies. Specifically, at OHTC there is a monthly departmental meeting, led by the unit manager and the clinical lead, at which the post-holder will be expected. There is a quarterly OHTC clinical governance meeting and the post-holder will be expected to attend. The post-holder will contribute to clinical governance by leading a rolling audit program for the inherited bleeding and haemophilia service and the post-holder’s team will be expected to present an audit at least annually. In addition, each consultant will contribute to the M&M review and will be expected to present an M&M, where relevant (again this is likely to be annually). As the clinical lead for haemophilia and the haemostasis laboratory, the post-holder will lead the teams to deliver quality improvement projects, where relevant, and this will likely involve one QIP every two years, per service.