Job description

Job responsibilities

Liver transplantationA liver transplant clinic is held every week on a Tuesday afternoon. This is for the management ofpre and post transplant patients. 3 consultants cover this clinic. There are currently ~ 100 posttransplant patients being managed at the Royal.Every 6 weeks a consultant from Birmingham provides a satellite clinic. Patients are fully workedup at the Royal and presented at this clinic to the Birmingham team prior to formal presentation atthe Birmingham transplant MDT. Other local trusts have the opportunity to refer into this clinic.Between 15-20 patients are referred for transplantation each year. The successful candidatewould be expected to ensure patients are worked-up and presented in a thorough and timelymanner.Viral HepatitisCurrently ~ 500 patients are treated annually for HCV infection across the ODN. The Royal is thehost site for the Cheshire and Merseyside HCV ODN. All DAA patients discussed at a MDT in conjunction with infectious disease colleagues. There is a weekly complex viral hepatitis clinic withthe regional infectious disease department on Wednesday mornings.HBV is managed jointly with ID and on average a trainee would see 15-20 patients/ month.HCC ClinicA dedicated HCC clinic and service is jointly run by the Hepatology team along with interventionalradiology weekly affording experience in staging liver cancer and locoregional / transplant work up/ best supportive care management strategies.NASH intervention serviceA dedicated multi disciplinary NASH service benefiting from a joint diabetes clinic and healthtrainers manages the needs the NAFLD cohort at high risk for poor outcomes.Autoimmune liver diseaseThe Royal runs the regional PBC ODN hub for second line therapies and this includes a monthlyPBC MDT which discussed complex regional patients with PBC who are suitable for additionaltreatment.General HepatologyThere are currently 2 general hepatology clinics / week. These manage all aspects of liverdisease. Currently there are > 250 patients on the PBC data base, ~ 60 patients on the PSC database ~ 200 AIH on the data base all of which are under regular follow up in these clinics. Patientswith cirrhosis are also managed in these clinics in conjunction with a comprehensive automatedHCC surveillance program with > 600 cirrhotics registered.The hepatology ward has between 25-30 hepatology and HPB patients at anyone time. A largevolume of the ward based work is management of the complications of cirrhosis.Currently ~ 2-3 patients / month are managed with severe alcoholic hepatitis. In parallel with theFriday liver clinic there is a Medical Alcohol Clinic run by Dr Lynn Owens a noted nationalspecialist in management of alcohol addiction with particular emphasis in anti-addictionpharmacotherapy. A weekly session with a consultant psychiatrist is also available to assesspatients for alcohol related brain damage. There is a comprehensive alcohol team embeddedwithin the hepatology department.The hepatology unit has a close working relationship with ITU colleagues and in the last year ~5% / year of patients on the 18 bed ICU were patients with complications of liver disease theseinclude patients with hepato-renal syndrome which also benefit from the input from the regionalrenal unit based in the RoyalThe Royal acts as a tertiary centre for the management of PHTN bleeding an on average 20-25emergency TIPS are performed each year for variceal bleeding. With cases discussed a a portalhypertension MDT. The hepatology unit works closely with the Pancreatic Unit for themanagement of biliary and pancreatic benign and malignant MDTs. Cases are discussed atweekly benign and malignant MDT with the pancreatic team. Complex non-cirrhotic portalhypertension secondary to pancreatic pathology is also managed in the benign MDT.The Royal manages ~ 30 -40 new HCC /year; all patients are discussed in a weekly MDT andmanaged subsequently in a weekly HCC treatment clinic. There are close working relationshipwith the Professorial oncology clinic led by Prof Dan Palmer

Specialist clinics.There is a joint adolescent transition clinic which is held with colleagues from Alder Hey Childrenshospital.EndoscopyThere is extensive opportunity for a trainee to continue endoscopy training with particularemphasis on endoscopic portal hypertensive lists. Potential exposure to complex HPB endoscopywith 4 ERCP and 4 EUS lists per week may be accommodated. A hepatology SpR would beexpected to contribute to the UGI bleeding rota and will be supervised and trained until sufficientlyexperienced to perform this role.Time Table Below is an example of a current time-table for a clinic block of work whilst at the Royal, but this will be flexible and aimed to meet the trainees needs. Currently we are working in 4 week blocks of work to allow concentration of exposure to ward, all OP clinics and endoscopy lists to ensure a comprehensive training package.

Person Specification

Qualifications

Essential

• MB, ChB/MBBS
• Full registration with GMC
• MRCP (UK)

Other

Desirable

• Pursue Higher degree (Masters or MD)
• Evidence of Audit
• Evidence of presentation in Research Meeting
• Evidence of publications
• Vision For Fellowship

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

Employer details

Employer name

Liverpool University Hospitals NHS Foundation Trust

Address

Royal Liverpool Hospital

Mount Vernon Street

Liverpool

L7 8YE

United Kingdom

Employer's website

https://www.liverpoolft.nhs.uk/ (Opens in a new tab)