The Clinical Oncology medical staff at PCH currently comprises six consultants; four are employed by NWAFT and one is employed by CUHFT (Addenbrooke’s Hospital) via a service level agreement. There are two Medical Oncologists and all common tumour sites (including breast, prostate, lung, upper and lower GI tract, gynaecology) are treated at PCH. Other tumour sites such as head and neck cancers and CNS tumours are referred to Addenbrooke’s Hospital but these pathways may well be reviewed in due course. Rarer tumours (including Paediatrics and Sarcoma) are referred to tertiary centres according to the formalised clinical pathways within the East of England Strategic Cancer Network.
The Trust has procured two Varian Clinac iX Dual Energy Linear Accelerators with advanced imaging and rapid arc IMRT capability, (employed for all prostate plans and three field breast plans and other tumour sites as required – over 50% of all plans at present) and a Toshiba Aquilion-LB CT Simulator. A third LinAc Truebeam has recently been commissioned.
The IT systems to be used alongside the fixed equipment include a: 4 Seat Treatment Planning System (Varian Eclipse), 4 Seat Virtual Simulation System (Prosoma) and an Oncology Management System (Varian Aria). We have 4D CT capability, SABR capability and gating facilities.
The catchment area for radiotherapy patients has now enlarged with the increased capacity. A further two consultant oncologists will be employed as per the business case for the new LinAc in addition to this post.
The radiotherapy service has recruited high quality radiographers and physicists, capable of developing and working to agreed protocols, and with the ability to take forward the technical radiotherapy and patient centred service.
The team is led by professional Heads of Service who work closely with the Medical, Management and other healthcare professionals to deliver a world class radiotherapy service. We are one of the highest users of IGRT in the country and use IMRT wherever appropriate.
The job plan would allow dedicated time for radiotherapy reviews and CT planning.
5 CLINICAL DIRECTORATE
The management structure of the Trust is the division of departments into Clinical Directorates (CD) with corporate support. The operational structure of each CD consists of a Clinical Director and a General Manager who assume operational and budgetary responsibility for all CD staff. They are also responsible for meeting national waiting and financial targets and ensuring most efficient use of resources within the CD. Each CD reports to the corporate body, Directors and Board via the Chief Operating and Executive Officers, in keeping with NWAFT’s status as a Foundation Trust.
The Cancer Unit within the CD comprises Medical and Clinical Oncology, Clinical Haematology, Day Centre and Palliative Care.
There are monthly Management and Governance meetings.
The unit is integrated with patients of all four disciplines being treated alongside one another in the in-patient area and day unit.
The Cancer Unit is a dedicated facility and is opposite the Robert Horrell Macmillan Day Centre. There is an 18 bedded in-patient facility with a dedicated side-room for Teenage/Young Adult Cancer, an out-patient area comprising seven clinic rooms and four radiotherapy assessment rooms. The day unit has 23 chairs and three beds for administration of chemotherapy and supportive treatments, (scalp cooling is available).
A number of outreach services have been established at Stamford Hospital, Doddington Hospital, Spalding Hospital and Oundle, the aim of which are to provide chemotherapy and routine haematology procedures, such as blood transfusions, closer to home.
The oncology team saw 1500 new patients in 2016.
There are two Consultant Medical Oncologists (one who also has sessions at Addenbrooke’s Hospital), two Palliative Care Physicians (who also have sessions at the Sue Ryder Hospice) and six Haematologists.
There is a visiting specialist registrar (SpR) in Medical Oncology and a SpR in Haematology based at PCH. An application has been made for a specialist training post in Clinical Oncology. There is one FY1 and three F2/ST posts allocated to the Cancer Unit together with a Trust doctor and a further Trust doctor allocated to the day unit.
The nursing establishment is led by the Modern Matron for Haematology and Oncology and the Lead Nurse for Cancer and Palliative Care. Chemotherapy is administered by both in- patient and day unit nurses. At present there are Clinical Nurse Specialists (CNS) in: Colorectal cancer, Upper GI malignancies, Lung Cancer and Haematology. The posts of the Skin cancer and Urology CNSs sit within the Surgical CD, and the Gynaecology CNS is part of the Family and Public Health CBU. Hospital Specialist Palliative Care CNSs and Community Macmillan nurses are members of the Cancer unit. Plans are underway to expand the CNS establishment.
We have an enthusiastic team of radiographers. We encourage radiographer lead review of patients on treatment and a consultant radiographer who takes up some of the palliative RT workload.
There are strong multidisciplinary teams in all cancer specialties with dedicated administrative support. The multidisciplinary meeting room has a videolink with other hospitals in the Anglia Cancer Network so video-conferenced meetings are arranged in some specialties. In some MDTs, such as hepatobiliary and lung, visiting surgeons attend the Peterborough MDT in person to ensure an integrated service.
The trials unit at PSHFT has a very strong record being the second highest clinical trial recruiter in the region. The unit is part of the West Anglia Cancer Research Network and there are seven trials team nurses (part or full funded by research networks), a trials radiographer and a trials administrator in post. Research is strongly encouraged, NWAFT has a fully functioning R&D committee, which meets monthly and reviews all clinical trials. It also conducts in-house audits of clinical trials. The unit has recruited strongly too many recent trials and the breast and lung teams are particularly active.
Teaching and Audit
PCH Department of Medicine has a long standing commitment to undergraduate medical education, taking students regularly from Leicester and Cambridge Universities, and sometimes from other areas. The postholder will be expected to take part in this teaching. The department also has an active postgraduate programme particularly aimed at the Senior House Officers and the MRCP.
NWAFT is one of eight acute hospital trusts within the Norfolk, Suffolk and Cambridgeshire Health Authority designated as a Postgraduate Medical Education Centre. An active programme of postgraduate education is provided on site.