Consultant - Nephrology

Detailed job description and main responsibilities

Department of Nephrology

Following the opening of the New Royal Hospital in October 2022, the Nephrology in-patient bed base has relocated and is consolidated across two wards in the New Royal Hospital. The Nephrology in-patient bed base has 42 beds (includes 8 regional renal High Care beds) and is co-located with Renal Transplant surgery who have 14 beds.  The new model ensures that ALL complex renal patients in the region (transplant, dialysis, AKI needing organ support, complex immunosuppression) have equitable access 24/7 to a bespoke MDT Tertiary unit.  

The Nephrology footprint extends beyond LUHFT’s sites; the LUHFT renal team provide all aspects of kidney care - Acute Kidney Injury (AKI); Chronic Kidney Disease (CKD); Renal Replacement Therapy (RRT); conservative management of patients who choose not to have dialysis/transplant; and transplantation across Merseyside, including parts of Cheshire (Population c.1.06m).  The Renal Transplant Unit provides services to the Wirral and North Wales (Population 2.5m). 

The Regional Renal unit has a 33 stationed dialysis unit in the lower ground floor, with 8 bedded High Care Unit in ward 7C and another 21 dialysis plumbed rooms between the wards 7C and 7B.

In response to the NCEPOD Report there is a robust and responsive strategy for management of acute kidney injury (AKI) both within the Trust and in outlying Trusts with an integrated alert programme highlighting new cases of AKI. There are satellite dialysis units at Broadgreen Hospital, St Helens Hospital, Warrington Hospital, Halton Hospital, Waterloo dialysis unit and Southport hospital. Clinical Governance for these patients rests wholly within the Royal Liverpool University Hospital Nephrology Directorate, within the Divisional and Trust structure for clinical governance and risk management.

The Renal Transplant Unit (RTU) serves Merseyside, North Wales, and the Isle of Man. The transplant team performs approximately around 100 renal transplants per year with a planned programme to increase to 120 per year. This includes an active living door transplant programme and a comprehensive programme involving both non-heart beating donation and ABO incompatible donor transplants. Major investment here recently includes the agreed planned expansion of Consultant Transplant Surgeon numbers from 5 to 6. All Consultant Nephrologists when on-call have a commitment to nephrology consultations in the RTU. As per national recommendation patients who have been transplanted for more than 12 months are transferred back to Nephrology and are seen in dedicated post-transplant follow up clinic. We also attend acute transplant clinics and perform in-patient transplant reviews.

There are excellent opportunities and facilities for research within the Trust. The present areas of interest within the Renal Unit are diverse and include inhouse research capabilities along with involvement in various national and international studies.

We are committed to submitting data to the UK Renal Registry and pursue the standards set in the NICE, UKKA standards and agreed yearly CQUINS with commissioners. There is a robust quality assurance management programme with regular MDT meetings and audit reviews.

Services:

Along with General Nephrology Clinic, we provide several sub specialist clinics including Immunosuppression Clinic, Renal transplant follow up clinic, home therapies clinic, Advanced Kidney care clinic, Dialysis clinic, Conservative Management Clinic, Polycystic Kidney Disease Clinic, Renal pregnancy clinic, Tuberous sclerosis clinic, Diabetic renal clinic, Myeloma-Amyloid joint haematology clinic. In addition, we run sub-specialist MDTs including Genomic MDT, Transplant MDT, Vasculitis/GN MDT.

Management:

Services operate under the following structure:

• Clinical Director – Dr Shahed Ahmed
• Head of Operations – Kate Brizell
• Associate director of Nursing – Tracey Cullen

Medical Staffing

We have 22 Consultants currently working within the Nephrology team:

• Dr Shahed Ahmed
• Dr Asheesh Sharma
• Dr Jay Hiremath
• Dr Anirudh Rao
• Dr Azri Nache
• Dr Christopher Goldsmith
• Dr John Alexander
• Dr Hannah Sammut
• Dr Harsha Wodeyar
• Dr Mark Devonald
• Dr Matthew Howse
• Dr Michael Schulz
• Dr Olivia Worthington
• Dr Philip Evans
• Dr Rema Saxena
• Dr Chukwuma Chukwu
• Dr Neil Bailey
• Dr Abraham Abraham
• Dr Bhavna Pandya
• Dr Cecilia Chow
• Dr Janice Harper
• Dr Christopher Wong

Job plan:

• The appointee, together with his or her colleagues, will have a commitment to the provision of general nephrology, specialist nephrology and acute medical services.

• The timetable is based on a 10 - 11PA job plan including 1.5 core SPA (example 8 DCC + 1.5 Core SPA + 0.5 educational SPA)

• The fixed clinical sessions will include a dialysis clinic, general nephrology clinic, speciality clinics which will be agreed with the post holder after appointment to reflect their specialist interests and service requirements.

• The on-call commitment is 1:20 on pro rota basis. The hot blocks on the wards occur on weeks 1,2, 11 and 12 in a 20-week cycle.

• Any SPA activity in the   job plan is designed to reflect time required for audit, mortality reviews, educational supervision, appraisal, and revalidation activity. This will be agreed with the post holder after appointment to reflect their specialist interests and service requirements. Additional DCC PAs and SPA’s may be available by mutual consent to meet departmental or organisational requirements.  The job plan will be reviewed six months after appointment and annually thereafter. Teaching and supervision of trainees will be an essential role of the post holder.  Level 2 training will be provided for the appointee to be an Educational / Clinical Supervisor if they have not already obtained such training. 
• The appointee is expected to attend and proactively commit to ongoing improvements in Nephrology & transplant MDT meetings, Renal Biopsy meetings, Clinical Directorate and Governance meetings.

• To receive acute referrals from Merseyside and Cheshire while on-call as part of the on-call consultant rota.

• The post holder would be expected to actively take part in audit, teaching and research.  The Unit has contributed to the Renal Registry since 2002.

• It is envisaged that the post holder would provide Consultant level nephrology cover for the Regional Renal Transplant Unit whilst on-call and support any future developments in the working patterns with the transplant team.

• The post holder will have continuing responsibility for the care of patients in his or her charge and for the proper functioning of the service.

• It is expected that the job involves educational and clinical supervision of junior doctors, specialist nurses and teaching commitments to medical students from University of Liverpool.

• The post holder will help in delivering directorate goals related to financial, clinical governance and QEP. Post holder will be subject to performance management through service line reporting.

At the Royal Liverpool University Hospital there are regular specialist and inter-disciplinary meetings including a weekly MDT radiology meeting, a bimonthly renal biopsy meeting. There is a regular lunchtime meeting and a Grand Round, which is open to staff of all specialties. There is a state-of-the-art education centre on site with excellent resources and personnel.

Job Plan & Timetable (While not on ward hot blocks and on call):

Hot blocks (Ward cover and on-call) occur on week 1, 2, 11 and 12 in a 20-week cycle and attract 3.3 PA .

This timetable is an example but may be subject to change and negotiable once appointed.

Please see attached Job Description for full details