Job responsibilities
Portsmouth Hospitals University NHS Trust is a provider of
Acute Health Services under contract to a range of Purchasers in the area of
the Hampshire basin and Western South Downs.
The catchment is in excess of 650,000 people. The area served by the Trust is on the Solent
and English Channel and includes the City of Portsmouth and the Boroughs of
Gosport, Fareham and Havant extending from Warsash in the west to Emsworth on
the Sussex border and its northern boundaries encompass Petersfield and
Liss. With the exception of the rural
north, it is an essentially urban area having grown up around the Royal Naval
establishments in Portsmouth and Gosport.
It now provides a wide range of modern high-tech industry and the
facilities associated with a commercial port and cross Channel ferry terminal.
Portsmouth is a thriving naval city, steeped in history, on
the South Coast. It is ninety minutes from central London and has good
transport links, including regular ferries to France and Spain. The major
airports are easily accessible. It has some of the best water sports facilities
in Europe and sandy beaches are within easy reach. Developments within the city
itself and on the Gosport side of the harbour suggest a vibrant future for the
area. Inland from the hospital is the
beautiful and relatively unspoilt countryside of rural Hampshire. Close by is
the New Forest and the recently designated National Park of the South Downs.
The area combines the advantages of city life with pleasant villages and
seaside towns. There are a number of first rate schools both in the state and
private sector and it is an excellent place to raise a family.
Portsmouth Hospitals University NHS Trust
Portsmouth Hospitals University NHS
Trust has a vision to be recognized as a world-class hospital, leading the
field through innovative healthcare solutions, focusing on the best outcomes
for our patients, delivered in a safe, caring and inspiring environment.
At present PHU provides the following services, Emergency Medicine,
Trauma and Orthopaedic Surgery, Oncology, Radiology, Orthodontic and Oral
Surgery, General and Specialist Medicine, General Surgery, Breast Screening and
Surgery, Plastic Surgery, Renal Services, Acute Medical Admissions,
Ophthalmology, Maxillofacial, ENT, Critical Care, Coronary Care, Elderly Medicine,
Rheumatology, Elderly Medicine, Rehabilitation, Dermatology and Neurology.
Staff turnover is currently 9.6%.
The Department
There are 120 general surgical beds at Queen Alexandra, a 24
bed Intensive Care Unit and a 10 bed Surgical High Care Unit (run by Surgery).
The Day Surgical Unit has 65 beds.
CT scanning, PET, EUS and MRI are on site with specialist
gastrointestinal radiologists and up to date facilities for diagnostic and
interventional radiology. In particular,
we have been collaborating closely with Professor Bhandari to develop a
state-of-the-art endoscopic resection service of international repute at
Portsmouth. We also have a comprehensive clinical and medical oncology service
on site with ready access to radiotherapy.
Most consultants also see outpatients at one or more
peripheral clinics, which include Petersfield and Fareham.
A Surgical Assessment Unit was opened in 2004 to provide a
modern facility for emergency surgical admissions. A DOSA Unit (Day of Surgery
Admission Unit) opened in 2010 and the majority of elective cases go through
it.
The UGI Surgical
Unit at Portsmouth is a recognised Cancer Centre for Oesophagogastric Cancer,
with a busy MDT drawing patients from the Central South Coast Cancer Network
(includes Portsmouth, Basingstoke, Chichester and Winchester). We routinely practice dual consultant
operating, with Minimal Access/robotic surgery being our standard approach.
Over the last 4 years we have implemented a Robotic Surgery program, using the
Da Vinci X and Xi surgical robots to assist with oesophagogastric cancer, benign
and emergency surgery.
We have a high
volume benign UGI practice with over 1000 laparoscopic cholecystectomies per
year (70% of them daycase and ~40% acute), and a busy tertiary referral
practice for anti-reflux surgery with over 200 fundoplications per year. We
share the General Surgical on call with our colorectal colleagues.
Hepatobiliary and pancreatic cancer surgical patients are discussed at the HPB
MDT on Fridays, with resectable patients going to Southampton for surgery and
palliative patients managed on site. We are a recognised Bariatric Surgical Centre
with 200+ cases per year.
The UGI Unit is based at Queen Alexandra Hospital. The UGI
Unit works as a team, with close collaboration among the consultants to provide
a unified approach to patient management.
We share responsibility for decision-making and risk management,
regularly operate together, and cover each others patients and lists when one
is away.
Inpatient treatment is based on ward E2. The Unit manages about 50-60 patients
undergoing oesophagogastric cancer resections plus a large number of patients
with benign disease per year.
Arrangements are in place for anaesthetic assessment, and we have
excellent relationships with the ITU team and Critical Care Unit.
There are ongoing audits of benign and bariatric work, and
data on the cancer patients are entered onto a local database and the NOGCA
database. All laparotomies are entered into the NELA database. A weekly Surgical Quality Assurance Meeting
takes place where outcomes & results are discussed frankly.
Major surgery is undertaken at Queen Alexandra Hospital in a
twenty eight theatre suite close to the UGI inpatient ward, offices, SAU, SHCU
and ITU (all on one floor E level). There is also a dedicated Day Surgical Unit
based on D level where most of our day surgical hernia and cholecystectomy
surgery takes place.
We have a high volume specialist hernia service including
major abdominal wall reconstruction. The
UGI surgeons also run the laparoscopic adrenalectomy service.
Our main theatres are E1 and E2, both of which are Storz OR1
endotheatres, opened in February 2010, paid for through charitable funds. These
are state-of-the-art theatres with multiple monitors and capacity for recording
and broadcasting live endosurgery. PHU has three Da Vinci robotic Surgical
Assistants, all with dual consoles, with currently the highest volume robotic
upper GI practice in the UK.
The Post
The post has been an RCS recognised senior clinical
fellowship in robotic oesophagogastric surgery for the past 3 years and
re-accreditation has been applied for. We aim to appoint a well-trained post-CCT
Fellow with a proven interest in robotic surgery. Training and experience in a
tertiary referral centre for UGI disease is essential, and a higher degree, UGI
publications and ongoing UGI research interests will be looked upon favourably.
Robotic UGI surgery experience is desirable, but not essential. Ability to work very flexibly as a team
member with existing colleagues is essential.
Minimal access surgical training in benign UGI surgery
(including cholecystectomy, hernias & hiatal surgery) is an essential part
of this post as most patients are operated on laparoscopically or robotically in
this unit including the emergency patients. Being a competent surgeon entails
more than just operative skills, and evidence will be sought as to the
appointee's ability & judgement to manage post-operative complications
and/or critically ill patients.
The successful candidate will provide 1 in 16 consultant
cover for emergency general surgical patients.
Full details of the post can be found on the Royal College
of Surgeons website: https://www.rcseng.ac.uk/education-and-exams/accreditation/rcs-senior-clinical-fellowship-scheme/national-surgical-fellowship-scheme-register/general-surgery/
Elective work:
The appointee will work directly with a team of 6 consultant
surgeons, 5 of whom have a major interest in oesophagogastric & bariatric
surgery. The appointee will be expected
to be familiar with, and to have had training in, all aspects of UGI surgery
including, oesophagogastric cancer, laparoscopic cholecystectomy (emergency and
daycase), fundoplication, laparoscopic hernia repairs (groin and incisional). Robotic
experience is looked upon favourably, but the purpose of this post is to train
the successful candidate in robotic surgery.
Emergency work:
The successful candidate will partake in the general
surgical on call rota on a 1 in 16 basis at consultant level . They will also
do 2 nights per month (non-resident) consultant general on-call.
Medical Staffing - Consultants
Marisia Walters
Shaw Somers
Simon Toh
Stuart Mercer
Nicholas Carter
Benjamin Knight
Gijs van Boxel
Phil Pucher
Michael
Glaysher
Trainees
Upper GI Senior
Clinical Fellow
3 STs
2 CTs
4 FY1
3 Specialist
Nurse practitioners (1 ward bases, 2 theatre based)
2 Clinical
Nurse Specialists for cancer
Education & Research
Undergraduate
Undergraduate
teaching is provided for fifth (final) year students from the Southampton and
Wessex Regional Medical School. The
attachment is for 8 weeks and each surgical specialty has 1 or 2 students. Student affairs are co-ordinated by the
Universitys Associate Dean in Portsmouth.
Post graduate
Monthly audit,
Surgical Divisional meetings, PRHOs curriculum teaching and STEP course
lectures for the SHOs are all programmed during this session, resulting in
protected time for all these activities.
There is a
dedicated minimal access training centre (VIMARS) on the Queen Alexandra
Hospital site. The consultants are part
of the Faculty and the centre provides regular hands-on & simulated courses
for basic and advanced minimal access surgery.
The UGI
Department runs several robotic courses, and the fellow will be expected to be
involved in these.
Excellent
library facilities exist in the Education Centre at Queen Alexandra Hospital.
