Clinical Component  

 Diagnostics & Breast Screening: 

Regular rapid diagnostic and screening assessment clinics are performed on the RLH & AUH sites; these are supported by Consultant Radiologists and Advance practitioners (both radiographic and nursing). We offer Mammographic, Tomosynthesis, Ultrasound and MRI breast imaging as appropriate.  Vacuum Assisted sampling via all modalities is available for both diagnosis and therapeutic needs within breast services. We utilise Savi-scout localisation for non-palpable lesions, with access to Wire localisation if the need arose.  Weekly results clinics and Breast Screening clinics are held between the RLH & AUH sites. We hold a weekly breast screening and main oncology MDT, a dedicated breast metastatic MDT occurs via Clatterbridge Cancer Centre with surgical representation. A management meeting and Oncoplastic meeting occur on a Monday morning with monthly-half day audit session as per the Trust timetable.  

The candidate will have exposure and training in all of these domains of practice.  

 Breast Surgery : 

Surgery is performed mainly on the RLH & BGH sites; we run theatre lists Monday-Saturday. All consultants offer oncoplastic techniques for conservation and whole breast reconstruction.  We have access to dopplers, ADMs, meshes and an implant bank on both RLH & BGH sites. Theatre 1st Assistants can help facilitate bilateral-synchronous operating as needed. Patient are supported to achieve day-case surgery with post-operative phone consultations and dressing clinic appointment managed by the nursing team. Patients attend for post-operative reviews in Results and Follow-up clinics on the RLH & AUH site.  The candidate will have opportunity to work with all the surgeons and experience the range of techniques offered. We would expect participation in clinics to observe the post-operative results.  

 Additional Services : 

We offer Family History, Benign Result, a B3-Risk assessment clinic and Genetic-Mainstream testing via our Breast ANP team. Prosthetic fitting and consenting is facilitated by our Breast Care Nursing & Reconstructive Nurse Specialists. Some consultants offer combined genetics-risk reducing consultations and Risk-Reducing Breast Surgery for high risk cases.  Breast Trials team are based at the RLH and recruit to a range of observational and interventional trials. Our plastic surgeon offers additional assistance with complex revisional cases and some benign/ cosmetic cases that have achieved NHS funding. The candidate will be welcome and encouraged to observe these services but would not be expected to deliver them.  

 Facilities in the Breast/Endocrine Surgery Unit 

The Breast and Endocrine Surgery Unit currently has access to in-patient beds in the Royal Liverpool Hospital (RLH), Broadgreen Hospital and occasionally Aintree University Hospital(AUH); with the majority of breast surgery managed as a day-case. 

The Trust is ‘paper free’ and we provide the relevant hardware to facilitate patient management via the electronic notes and prescribing systems.  This also allows the candidate to manage their administrative tasks from any site in a flexible manner. 

 The RLH & AUH are exceptionally well equipped for all diagnostic and therapeutic procedures necessary for the efficient care of breast/endocrine surgery patients.  There is 24-hour access to the emergency theatres and all routine pathology services.  The radiology department is equipped for emergency and elective diagnostic procedures, including US, MR and CT/PET-CT scanning.  The library facilities in the hospitals are supplemented by excellent medical libraries at the Liverpool Medical Institute.  Postgraduate teaching is provided by in-house seminars, MDTs and audit meetings.   

Research 

The Unit has a good record of clinical investigation with high rates of recruitment to breast trials; with staff contribute regularly to national and international meetings.  As a teaching hospital the post holder will have the opportunity to participate in audit and clinical research.  

Key Unit Staff at Royal Liverpool Hospital (RLH) & Aintree University Hospital (AUH)  

Ms Alison Waghorn (Breast Services lead -Consultant Surgeon )   

 Ms Emma de Sousa (Consultant Oncoplastic Breast & post-graduate Educational Lead ) – Please contact for further information regarding this post.  [email protected] Tel: 0151 706 4712 

 Mrs Julia Henderson (Consultant Oncoplastic Breast Surgeon & Clinical Lead Breast Surgery) 

Mr Mysore Chandrashekar (Consultant Oncoplastic Breast Surgeon) 

Mr Matthew Rowland (Consultant Oncoplastic Breast Surgeon & Endocrine Surgeon) 

Ms Hiba Fatayer (Consultant Oncoplastic Breast Surgeon) 

Mr Lee Martin (Consultant Oncoplastic Breast Surgeon) 

Ms Geraldine Mitchell (Consultant Oncoplastic Breast Surgeon & Divisional Medical Director for Surgery RLH) 

Mr Simon Timbrell (Consultant Oncoplastic Breast Surgeon) 

Mr Jamie Barnes (Consultant Plastic Surgeon) 

Mrs Anu Shrotri (Director of Breast Screening &  Oncoplastic Breast Surgeon) 

Mr Mohmed Lafi (Senior Breast Surgeon ) 

Dr Asha Shivaram  Consultant Breast Radiologist & Clinical Lead 

Dr Sheetal Sharma Consultant Breast & Interventional Radiologist  

Dr Liam Swainbank Consultant Breast & General Radiologist  

Dr Mohamed Abdelhadi Consultant Breast Radiologist 

Dr Alex Roberts Consultant Breast Radiologist  

 Unit Manager Mrs Lesley Nutbrown  

Lead Nurse – Sister Nicky Gilham   

Endocrine Surgery  

Miss Susannah Shore (Consultant & Clinical Lead Endocrine Surgery ) 

Mr Robert Hardy (Consultant Endocrine Surgeon & General Surgeon) 

Mr Neil Houghton (Consultant Endocrine & Emergency Surgery ) 

Miss Helen Perry (Consultant Endocrine & Emergency Surgery )  

Other surgical staff consist of Specialist Registrars (ST3-8), CT doctors and FY1s doctors. 

There is a team of Theatre First Assistants,  Breast Advanced Nurse Practitioners, Breast Care Nurses, Breast Reconstruction Nurse, and pre-operative assessment nurses; split across the 2 sites.   We have a dedicated team of administrative and clerical staff including in-patient booking.   

 The Clinical Load 

The Liverpool University Foundation Hospital Trust is a busy tertiary referral centre for breast & endocrine surgery.  Patients are referred to the Unit from across Merseyside and in some cases from the Isle of Man for specialist input.  There is collaborative MDT working with medical and clinical oncology colleagues from Clatterbridge Centre for Oncology.  

Teaching 

Medical students are attached to the breast & endocrine surgery unit.  The post-holder will be expected to give clinical teaching and occasional lectures to undergraduates.  There is also nurse training and mentorship to which we would encourage participation with.  

 Duties 

Attend regular operating lists, outpatient clinics, audit and academic meetings and MDTs. Some operating lists maybe on a Saturday (0800-1530) and some clinic in the evening hours for 1700-2030; additional payment for these sessions is available.  Take part in daily morning ward rounds to be held with all the other junior surgical staff on duty.  

Support the pre-operative nursing team remotely with clinical decision making and specialist referrals to aid peri-op assessment. 

There is no Out of Hour On call as part of this post; but if this is important to the post-holder we can facilitate participation on an ad hoc or regular basis.  Duties will include assisting on the regular Saturday theatre lists (1:4) and an alternate week Wednesday evening rapid assessment clinic. 

Conditions of Service 

This post is covered by the Hospital Medical and Dental Staff (England and Wales) Terms and Conditions of Service. The post holder is required to be fully registered with the General Medical Council (GMC) and hold a licence to practice.