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Histopathologist

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  • 1. Appendix 2 APPROVAL OF CONSULTANT APPOINTMENTS CRG/BOARD AND PCT APPROVAL REFERENCE NUMBER …007.1 This proforma should be accompanied by the 2 nd stage Business Case proposal. LEEDS TEACHING HOSPITALS NHS TRUST TITLE OF THE POST : CONSULTANT HISTOPATHOLOGIST WITH A SPECIAL INTEREST IN SKIN AND CARDIOTHORACIC PATHOLOGY PROPOSAL FOR: (tick) Replacement Post: 0.6wte replacement New Post: 0.4 wte new Other: (please detail in text) FULL TIME/PART TIME (please detail number of Programmed Activities) Full time 10PAs Base Hospital: LGI SECTION 1 : REQUIREMENT FOR THE POST : Final. August 2004 1
  • 2. a) Why is the appointment needed and how does the post fit with the agreed PCT/Trust plans for service provision? (Please give any contact in PCTs with whom the post has already been discussed). 1 LGI Group 3 pathologists currently have an excessively heavy work load of dermatology (Trust & Primary Care cases), cardiothoracic (including Cancer Centre thoracic oncology) and soft tissue (including Cancer Centre sarcoma) cases. The present 4 pathologists have 26 direct clinical care PAs and a workload of 14359 cases in the 12 months 09/03 to 08/04. RCPath guidelines have proposed a workload of 2000 cases per WTE (7.5 clinical PAs) Consultant. Even allowing for 2000 Primary Care dermatology cases most but not all of which are relatively straight forward the current level of staffing places strains on the incumbent pathologists. Dr Andrew Jack, a previous Group 3 Consultant (0.6 WTE)) has been a full-time haematopathologist funded by HMDS since 01/04/04 and has not been replaced. If no new appointment is made it is likely that one or more of the present Group 3 team will seek employment elsewhere. Salaries are on offer at levels considerably above the basic 10PA level, both locally and nationally. 2 Ability to meet National Targets for diagnosis & treatment is currently being compromised by this lack of Consultant staffing in Pathology Group 3. National targets for skin cancers will be introduced in 2006/7. These are expected to require some centralisation of services and increased workload for the Group 3 pathologists. Staffing levels in other Pathology Groups in the Trust are insufficient to provide satisfactory support to Group 3. 3 Thoracic surgery is due to centralise in Leeds in 2005. This appointment will ensure that an experienced pathologist is in post to support this additional workload, including intraoperative biopsy cryostat sections and MDT meetings. 4 A new dermatology consultant appointment has been approved . This requires 0.1WTE (1 direct care PA) histopathology consultant support. 5 Histopathology support for the Sarcoma Service is currently provided by Group 3. Funding at a level of 2PAs is provided for this but is currently not being used for this purpose. The CMT understands that this is a recurrently funded SRS development. The role of histopathology is critical in the delivery of the Sarcoma service throughout the region. 6 The Postgraduate Deanery provides funding to the Trust at a level of 2PAs for Histopathology Training Committee work currently done by Dr Merchant (11PA Group 3 Consultant) that is currently not being used for this purpose. The deanery contract is reviewed annually and the CMT is assured that there are no plans to reduce the level of funding to this service. However, should the funding be reduced, given the importance of the post, the CMT will find alternative funding from within its own resources 7 A potential interested applicant is currently available for a 10PA appointment. This pathologist has trained in Leeds and has recently received a CCST. She has a specific interest in dermatopathology and is currently employed as a locum covering this proposed substantive post. In view of the national 13.9% vacancy rate for histopathology consultant posts and the availability, both locally and nationally, of salaries at levels considerably above the basic 10PA level we are fortunate to have such a potential candidate. Final. August 2004 2
  • 3. b) Is the proposed new post documented in the CMT’s Business Plan and covered : i) in the Leeds LDP? ii) by National policy documents? iii) by Network funding? iv) other (e.g. New Oncology Wing FBC) YES: NO: Final. August 2004 3 NO NO NO
  • 4. SECTION 2. JOB PLAN a) Please indicate the job plan programmed activities (normally 7.5 Direct Clinical Care and 2.5 for Supporting Professional Activities). - How many for Direct Clinical Care? - How many for Emergency work arising from on call rotas? - How many for supporting professional activities? - How many for additional responsibilities? 7.5 2.5 b) If there is any variation to the 7.5/2.5 split, please give reasons why. c) Are additional Programmed Activities above 10 PA’s to be offered and, if so, please give reasons why, and state for how long (up to two maximum). NO d) Please outline the objectives of the post. 1 Provide & develop histopathology services for dermatology, respiratory medicine, cardiothoracic surgery, cardiology and sarcoma patients. 2 Perform & report Trust autopsies. 3 Participate in the departmental clinical audit programmes. 4 Participate in the teaching & training of undergraduate medical & dental students, trainee medical staff in histopathology & other specialties and biomedical scientists. 5 Participate in & develop the departmental research programmes. 6 Participate in departmental management & administration. e) Does this post impact on other job plans in the specialty, e.g. reduction in additional programmed activities for other job plans? NO Final. August 2004 4
  • 5. Please provide current and proposed specialty job plan summary. f) Does this appointment change the frequency of others on the rota NO (i.e. is there a reduction in the availability supplement?). Final. August 2004 5
  • 6. g) What sub-specialty interest is planned and why? Cardiothoracic pathology & dermatopthology. This post is to support the provision of histopathology services primarily for cardiothoracic and dermatology patients h) Is this subspecialty interest a new one? NO: i) Does it follow the interest of the previous incumbent? YES: SECTION 3. LOCATION AND KEY LINKS (internal and external) a) Will the postholder work entirely within this Trust? (please give details) YES: b) If Clinical Academic post – is there University agreement? Give details of University element of the job plan. NHS post c) Key clinical dependencies (include clinical support services and other specialties) Thoracic oncology MDT, Dermatology CPC, Malignant melanoma MDT Final. August 2004 6
  • 7. SECTION 4. ACTIVITY – Planned outcome in terms of activity and quality (where applicable). a) Agreed baseline activity Estimated change of activity for the appointee PYE FYE Total revised activity for the Specialty (NB describe the acute/elective split below) PYE FYE IP FCEs DC FC Es 1 st OPs b) If no additional activity, please state why not. The work to be done by the proposed appointee is currently being carried out by four pathologists (26 clinical PAs) who have workloads well in excess of nationally recommended levels (see Section 1a above) c) Impact on contract income (to include assessment of any displaced activity) None Final. August 2004 7
  • 8. SECTION 5. RESOURCES a) Post: Estimated Start Date Locum: xxxxxxxxx Estimated Start Date Substantive: 01.02.05 In Year Full Year WTE Recurrent £000’s Non Recurrent £000’s WTE Recurrent £000’s Pay Direct Staffing Medical - Minimum Salary (WTE) - Programmed Activities - Availability Supplement - Premium Rate hours - CEA (current) 1 1.00 £15.5 1.0 £92.9 Consultant (inc Locum Cover) Junior – specify Nursing Ward Other – specify Secretarial Other – admin Other – specify Pay Support Staffing Theatres Anaesthetists Other – specify Outpatients – specify Therapies – specify Pathology – specify Radiology – specify Pharmacy – specify Facilities – specify Other – specify TOTAL PAY COSTS 1.00 £15.5 1.00 £92.9 Non Pay Removal expenses £12.0 Advertising £0.8 Training/Travel £1.0 £1.0 Drugs Ward consumables Other consumables Lease/Maintenance Theatres – specify Outpatients – specify Therapies – specify Pathology – specify Radiology – specify Pharmacy – specify Facilities – specify Other – Camera and Computer £4.0 TOTAL NON PAY COSTS £1.0 £16.8 £1.0 1 Insert details of average funds to cover an appointee who comes with existing award. Final. August 2004 8
  • 9. CAPITAL CHARGES TOTAL REVENUE EXPENDITURE £16.5 £16.8 £93.9 CMT Income Provider – provider Private patients Research Service Agreement Income TOTAL CMT INCOME NET REVENUE IMPLICATIONS £16.5 £16.8 £93.9 IMPACT ON CONTRACT INCOME Capital Resource Requirement Equipment – specify Microscope £17,000 Facilities – specify Other – specify TOTAL CAPITAL IMPLICATIONS £17.000 Final. August 2004 9
  • 10. b) Define the funding source/sources. 6PAs from Dr Andrew Jack, previous 0.6 WTE Group 3 Consultant who has been full-time haematopathologist funded by HMDS since 01/04/04. This funding is within the Histopathology budget (approx £67k). 2PAs SRS funding for Sarcoma Service histopathology. This funding was released into the pathology budget in 2002/03. Funding level in 02/03 was £11.7 which when uplifted by PA and superann changes would be £13.1k in 04/05. This funding has not been increased for the change to the new consultant contract as they have been vacant. 2PAs from Postgraduate Deanery (Dr Burr) for Dr Merchant’s for Training Committee work. This funding will be approx £18.6k. Non pay costs of travel and training are funded from within the current Pathology budget. Recruitment and removal expenses will be funded from within existing resources in Corporate Personnel as this is a replacement post. c) Please demonstrate the impact of this case on the CMT recurrent financial position. All recurrent revenue costs of the post are funded either within the CMT budget or through additional funding from the post graduate deanery. The CMT will need to identify capital funding of £17,000 for the microscope. The vacant sessions within the pathology budget are currently resulting in an underspend on the pay budget. This post has not however been identified in the pathology Recovery Plan as one that can be removed from the establishment. Final. August 2004 10
  • 11. SECTION 6. ACCOMMODATION a) Please identify where the accommodation required is to be sited : i) Office for the Consultant and Secretary Algernon Firth Building, LGI ii) Office for other staff to be appointed as a result of the post; None iii) Clinical (e.g. O/P sessions, theatre sessions, beds, critical care beds, etc). None Please note: If new accommodation/sessions are required, this must have been resolved before the Business Case is approved. SECTION 7. TIMETABLE a) Please indicate the proposed timetable for recruitment, if approved. CRG Approval -15/10/04 Trust Board Approval -15/11/04 Advert -01/12/02 Interview -01/01/05 In Post -01/02/05 Locum Potential (Date) - Locum in post Final. August 2004 11
  • 12. b) Please name the individual responsible for the monitoring and the date for review. Dr Ian Barnes-Head of Pathology CMT THIS FORM MUST BE COMPLETED TO ENSURE OWNERSHIP BY ALL AFFECTED CMTs (INCLUDING ALL CLINICAL AND NON CLINICAL SUPPORT CMTs) OF THE RESOURCE IMPLICATIONS IDENTIFIED IN THE BUSINESS CASE (ALL NAMES BE ADDED WITHIN SEVEN DAYS OF CIRCULATION) C.M.T./CORPORTA TE FUNCTIONS SUPPORTE D Yes/No COMMENTS SIGNED CHECKED BY Signed: …………………………………………………..……………………….. Date Final. August 2004 12
  • 13. …………………… Head of CMT Signed: …………………………………………………..……………………….. Date …………………… Assistant Director of Finance HR SIGN OFF FOR CONTRACT/SALARY IMPLICATIONS Signed : …………………………………………………………………………….. Date ………………… Head of Personnel AUTHORISED BY Signed: …………………………………………………..……………………….. Date …………………… Appointing Director of Operations Signed: …………………………………………………..……………………….. Date …………………… Trust Director of Finance Final. August 2004 13