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SOUTH TEES HOSPITALS NHS FOUNDATION TRUST

SENIOR SPINAL FELLOW

SPINAL SURGERY

BASED AT THE JAMES COOK UNIVERSITY HOSPITAL

AND THE FRIARAGE HOSPITAL

JOB DESCRIPTION

The James Cook University Hospital

Marton Road, Middlesbrough, TS4 3BW

The Friarage Hospital

Northallerton, North Yorkshire, DL6 1JG

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SENIOR SPINAL FELLOW (SpR) SPINAL SURGERY

SOUTH TEES HOSPITALS NHS FOUNDATION TRUST

THE TRUST

 South Tees Hospitals NHS Trust provides health care from two main sites – The James Cook University Hospital in Middlesbrough and the Friarage Hospital in Northallerton.

The Trust is the cancer centre within the Teesside, South Durham and North Yorkshire Cancer Care Alliance and Trauma Level I Centre. The Regional Spinal Injuries Unit provides a comprehensive Spinal Cord Injury service for the North of England (population 3.4 million).

It also covers a range of specialised services extending to 1.5million people in Teesside and parts of Cumbria, Durham and North Yorkshire with leading expertise in heart disease, cancer, trauma, neurosciences, renal services, specialised spinal surgery and spinal cord injuries.

Medical specialities within The James Cook University Hospital include Cardiology, Respiratory Medicine, Neurology, Gastroenterology, Diabetes and Endocrinology, Nephrology, Haematology, Elderly Care, Genito-Urinary Medicine, Brachytherapy, Dermatology, Rheumatology and Rehabilitative Medicine.

Surgical specialities include cardiothoracic surgery, Neurosurgery, Ophthalmology, Otolaryngology, Vascular Surgery, Plastic and Reconstructive Plastic Surgery, Burns, Urology, Orthopaedic and Trauma Surgery, Maxillofacial and Orthodontics. There is also Paediatric and Neonatal Medicine, which are linked with Obstetrics and Gynaecology.

THE JAMES COOK UNIVERSITY HOSPITAL

The James Cook University Hospital in Middlesbrough has all its specialties on one site which is unique for a hospital of its size.

JCUH is a designated Major Trauma Centre and Specialist Spinal Centre with a full range of support services including the Orthopaedic and Neurosurgical Units, a Plastic Surgical Unit, a Cardiothoracic Unit, and a Maxillo-Facial Unit; with an on-site helicopter-landing pad.

JCUH is a designated Cancer Centre, with a catchment area of approximately 1.25 million. At present the cancer specialists see approximately 60 patients a year with neurological involvement from spinal metastases. There has been a general increase in referral of patients with complications from cancer consequent of achievement of the Cancer Centre Status and this number may increase.

There are 22 operating theatres, a twenty bedded ITU, PICU and General, Neurosurgical and Spinal Cord Injury HDUs.

There is a 21 room imaging department equipped with a full range of mainly digital modalities, a trust-wide PACS system and a purpose built 6 bed radiology day unit. 24/7 MRI and CT are available.

The central clinical laboratory provides pathology services. There are computer links between this laboratory and most wards and departments.

There is a purpose-built surgical day unit and an endoscopy centre. The district pharmacy department is on site as is the supra-district Public Health Laboratory Service. A Medical Physics Department is also on this site together with isotope imaging.

The Regional Ultrasound School, School of Midwifery and School of Anaesthesia are also on site.

SPINAL SERVICES

The spinal team comprises five orthopaedic spinal surgeons and three spinal neurosurgeons ( Mr Kalyan, Mr Hekal, Mr Alrawi, Mr Sewell, Mr Tizzard, Mr Prasad and Mr Aziz). There is a joint on-call rota for spinal emergencies. The orthopaedic team is supported by an associate specialist, a rotating registrar, one senior fellow (this post), two fellows and two nurse specialists. Joint meetings of the centre take place weekly.

The Regional Spinal Cord Injury Centre is located at The James Cook University Hospital, and serves the whole of Northern England. The Centre admits approximately 50 acute spinal cord injuries per year.

There is an active spinal deformity service provided by three Consultant Orthopaedic Surgeons. Spinal cord monitoring is used in all deformity cases in theatre. Non-invasive body shape mapping is used in out-patients (ISIS Scanner). Joint working with the paediatricians is backed up by a Paediatric ITU. A Scoliosis Specialist Nurse provides support to the scoliosis service.

Work in the Neurosurgical Department includes amongst a varied complex spinal service an active practice in cervical surgery including atlanto-axial and major reconstruction cervical surgery. Intradural and trans-oral surgery is also performed at this centre.

There is a very large practice spinal surgery for degenerative and other conditions with four Orthopaedic Spinal Surgeons and seven Neurosurgeons. There are 82 Orthopaedic in-patient beds plus spinal injury centre beds and a Day Case Unit for 23 patients. There is twenty four hour scanning with a dedicated consultant radiologist rota. There is a neurophysiology department, a large neurology department and spinal cord monitoring.

The Spinal Assessment Clinic is run by three Nurse Practitioners and was the first clinic in the United Kingdom set up on this basis. The clinic runs a fully computerised audit system and 80 per cent of patients seen are diagnosed and treated solely by a Nurse Practitioner. Patients with surgically remediable lesions are fast tracked through to scanning and for surgical opinion. The clinic now sees 1500 patients per year.

There is a specialist musculo-skeletal radiologist within the general radiology division working closely with three neuroradiologists in an active Neuroradiology Department undertaking all specialist spinal radiology including interventional procedures.

Four full day spinal operating lists run at the James Cook University Hospital and three lists at the Friarage Hospital. Two neurosurgical lists run daily with a high spinal caseload.

Personnel

At the present time there are twenty six Orthopaedic Surgeons, of whom four have a special interest in spinal disorders, and two consultants in Spinal Cord injuries (Mr. M. Mecci, Dr Aung). Professor Rangan leads the academic work with close links with Durham University.

There are seven Consultant Neurosurgeons of whom three have a special interest in spinal disorders.

The Spinal Injuries Unit has brought together as a team eight surgeons who make up the Teesside Centre for Spinal Disorders. These are Mr Tizzard, Mr Hekal, Mr Kalyan, Mr Alrawi, Mr Prasad, Mr Sewell and Mr Aziz. There is a complex spinal neurosurgical consultant vacancy at the present time.

Senior Spinal Fellowship Directors

Mr Simon Tizzard is a neurosurgeon with a major interest in spinal surgery and undertook an orthopaedic spinal fellowship in Adelaide, South Australia. His special interests are complex spinal surgery, minimally invasive spinal surgery, spinal tumours and Chiari malformation. He is the Clinical Director of Spinal surgery and Neurosurgery.

Spinal Consultants

Mr Raman Kalyan has a major interest in paediatric deformity and trained in Belfast, Stanmore and Nottingham

Mr Waleed Hekal has a major interest in deformity and trained in Great Ormond Street, Nottingham and Sydney, Australia.

Mr Asif Alrawi has an interest in malignant disease together with trauma and degenerative work.

Mr Mathew Sewell has a major interest in deformity and trained for two years in Australia and Exeter as a spinal fellow.

Mr Aziz has a major interest in spinal surgery including minimally invasive spinal surgery, fragility fractures and the surgical treatment of chronic pain. He was the spinal fellow at James Cook University Hospital as well as completing his training in Sheffield and Hull.

Mr. Prasad has a major spinal interest.

Mr Hekal, Mr Sewell and Mr Kalyan each have the assistance of a spinal Fellow.

THE POST

The senior fellow will spend 12 months working with Mr Tizzard. The trainee would attend both orthopaedic and a neurosurgical spinal interest clinic as well as spinal operating lists for both specialities. In addition the trainee will also have a commitment to the Regional Spinal Cord Injuries Centre.

Proposed Timetable (subject to change)

| |Monday |Tuesday |Wednesday |Thursday |Friday |

| | | | | |Spinal Unit Meeting |

|AM |Theatre |OPD |Theatre |Theatre | |

| |Deformity |Mr Tizzard |Mr Tizzard |CGG | |

| | | | | | |

|PM |Theatre |Research |OPD |Theatre |Joint OPD |

| |(ad hoc) | | |CGG |(monthly) |

There are numerous opportunities for additional operating on a regular weekly basis with Mr Tizzard and the fellow is welcome to join the other spinal surgeons as time allows.

On call (non-resident) is 1:8

Training

All the clinical and theatre session will be supervised by the consultants and aim to deliver high quality advanced professional training in spinal surgery.

At the end of the year the post holder should be prepared to undertake consultant post in spinal surgery

Consultant:

Mr S Tizzard MA FRCS

Consultant Neurosurgeon

Research

The trainee will be expected to have an active involvement in research. We encourage the trainees to publish a scientific paper in a peer review journal every year, or get involved in a research degree (MD/PhD). Ample time will be allocated in weekly timetables for research.

Clinical Audit

You will be expected to participate actively in clinical audit and to attend the regular departmental audit and governance meetings and morbidity meetings. Ample time will be allocated in weekly timetables for audit. We recommend that you complete one audit every year and to make the effort to present it regionally or nationally.

Clinical Meetings

There is a weekly, half-day regional postgraduate teaching in Orthopaedics, which are mandatory for orthopaedic trainees and you is expected to attend at least 75% of them in each year. There is a weekly spinal surgical MDT which you are expected to attend. We also have a monthly audit meeting for the department and you will be expected to attend.

LOCAL AMENITIES

Leisure/Recreation

There are major shopping centres at Teesside Park Middlesbrough and Darlington. Newcastle and Gateshead Metro Centre are within reach, as are the historical Cities of York and Durham. Hartlepool Marina and Hartlepool Historic Quay and Maritime Museum are part of a multi-million pound development also only a short distance away.

There are excellent facilities in the area for most sports, including golf, swimming, squash, rugby, cricket and tennis. There is an excellent indoor tennis centre (David Lloyd) close to the Durham University campus in Teesdale (4 miles from the James Cook University Hospital) and there are excellent golf courses at Wynyard and Romanby near Northallerton with driving range facility. The Tees Barrage has allowed the creation of simulated white water canoeing and rafting centre in Teesdale that attracts canoeing enthusiasts from all over the UK.

There is easy access to the coast, the North Yorkshire Moors National Park, the Pennines and Dales. There is an extensive range of recreational and cultural facilities in the immediate vicinity. The Cleveland hills offers opportunities for a variety of outdoor pursuits, including rambling, gliding and hang-gliding. There is active support for the arts in the region, both at professional and amateur level, with a wide range of cultural events and activities available. These include theatre, ballet, opera and all types of music, as well as a variety of museums.

There are multi-screen cinemas in Middlesbrough, Teesside Park (Stockton), Hartlepool Marina and Metro Centre (Newcastle) with bowling facilities at Teesside Park and the Metro Centre. Middlesbrough, Stockton, Yarm, Stokesley, Great Ayton and Northallerton have a number of pubs serving food and with facilities for children. The majority of small towns and villages surrounding Middlesbrough and Northallerton have excellent restaurants offering a variety of different cuisine.

The enthusiastic spectator can follow all football, rugby and cricket. Middlesbrough Football Club has a superb new ground on the developing Middlehaven site, close to the banks of the river Tees (Riverside Stadium).

Housing

There is a choice of housing in comfortable residential areas in the many pleasant rural and urban areas in the surrounding countryside and within easy reach of the trust. Stokesley, Great Ayton, Eaglescliffe, Yarm and the surrounding villages offer a range of quality houses at sensible prices, among the lowest in the UK. A range of executive houses is available, including exclusive developments at Wynyard, Nunthorpe and surrounding villages. Marske and Saltburn by the sea offer the opportunity to live by the sea and there are many beautiful village locations at the edge of the Dales National Park area accessible from Northallerton.

Education

The James Cook University Hospital has an on site crèche. There is a complete range of educational facilities ranging from nursery to higher education, with Universities at Teesside, Durham, Sunderland and Newcastle, offering a wide choice of degree courses. The local secondary schools are comprehensive and many in Nunthorpe, Stokesley, Yarm and Eaglescliffe enjoy an excellent national reputation with high positions in the league tables. There are also excellent local private schools in Yarm and Eaglescliffe as well as a number of first class preparatory and public schools in the area.

Transport

Road communication is excellent in all directions allowing quick and easy commuting.

Road: The A19 links to the A1 (M) and the A66 links Teesside to the beautiful Lake District and Cumbria. Travel time to the Lake District is just 1.5 hours by car. Whitby and York are just 1 hour away

Rail: Darlington and Northallerton railway stations are only a short driving distance away, from which London is 2.5 hours away and Edinburgh 2 hours.

Air: Durham and Tees Valley International Airport is also about twenty minutes from Middlesbrough and has frequent services to London, Amsterdam, Dublin and a large number of holiday destinations both in the UK and abroad.

Newcastle and Leeds/Bradford International Airports are within easy driving distance.

MAIN CONDITIONS OF SERVICE

1. The Terms and Conditions of Service will be those agreed between you and the Trust Board. At the time of writing these will reflect the Terms and Conditions of Service of Hospital Medical and Dental Staff (England and Wales) and General Whitley Council Conditions of Service, and may be amended from time to time. The salary scale is in accordance with nationally agreed rates of pay and varies from time to time in accordance thereto. At present the scale is from £30,605 to £48,123 per annum.

2. The appointment will be for 40 basic hours plus on-call commitment

3. The appointment will be subject to a medical examination with the Trusts Occupational Health Department.

4. The post requires enhanced DBS clearance as you will come into contact with children.

5. You will be required to give South Tees Hospitals NHS Trust 4 weeks notification of termination of employment.

6. The post holder will be entitled to annual leave pro rata to 27/32 days per annum (dependent upon experience). The Trust is committed to CME and CPD and study leave and funding may be granted, subject to Trust procedures.

7. Study leave will be granted subject to the exigencies of the service, under the terms and Conditions of Service for Hospital Medical and Dental Staff and in line with Northern Deanery guidelines. Approval from the trainee’s Educational Supervisor is expected, and an Educational agreement should be completed before leave is approved.

8. You will undertake the Trusts mandatory training (and/or equivalent induction training)

9. The position you have applied for is exempt from the Rehabilitation of Offenders Act 1974 (as amended in England and Wales). When South Tees NHS Foundation Trust is assessing your character and suitability for any such appointment, it is legally permitted to ask for and consider any information relating to unspent (current) and spent (old) criminal convictions, police cautions, final warnings or reprimands which are not protected (or filtered out) by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2013. Any failure to disclose such convictions could result in disciplinary action by the Trust. Any information given will be kept in strict confidence and used only in relation to the position in which the order applies.

10. The post holder will have a general duty of care towards colleagues, patients and the general public and act in accordance with the requirements of the Health and Safety at Work Act 1974 and its associated regulations.

GENERAL INFORMATION

This hospital is now taking part in a The Hospital @ Night initiative. The post holder will be expected to contribute to any local or national projects which will benefit patients.

VISITING ARRANGEMENTS

Short-listed candidates are encouraged to visit the Unit and meet with the prospective Colleagues.

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