The Posts and the Training Programme
The posts are designed to provide a comprehensive, four year higher training programme to equip individuals to become consultants in Palliative Medicine working in a variety of clinical settings. The rotation offers experience of Palliative medicine practised in several hospices (Wakefield Hospice; St Gemma’s and Wheatfields Hospice, Leeds; Manorlands Hospice, Oxenhope; Marie Curie Centre, Bradford and St Catherine’s Hospice, Scarborough) and with hospital palliative care teams (Leeds Teaching Hospital Trust with bases at Leeds General Infirmary and St James University Hospital; Airedale hospital, Keighley, Bradford Royal Infirmary, Bradford; York District General, York) throughout Health Education England - Yorkshire and the Humber. Specialist registrars on the rotation can expect to work in Leeds, Bradford, Wakefield and Scarborough at some point in their training.
Experience of specialist pain management, medical oncology and clinical oncology are part of the core training programme. Additional experience in relevant related specialities such as liaison psychiatry, rehabilitation medicine and paediatric oncology is also available as appropriate. Training opportunities are tailored to the needs of individual specialist registrars as far as possible, based on regular appraisals and annual assessments by the Yorkshire Regional Palliative Medicine Training Committee.
Higher training posts in Palliative Medicine were first created in Yorkshire in 1991 with pump-priming from Macmillan Cancer Relief. Since that time the programme has grown to include 12 full time posts with 9 flexible trainees currently. This has allowed the development of excellent opportunities for joint clinical weekly meetings, for regular journal club, joint audit and research projects and the regional learning group. Links between palliative care, chronic pain relief and oncology services are strong.
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The training rotation in South Yorkshire is based around Sheffield and Chesterfield, during which there are one year placements in inpatient units, hospital support teams, community or research.
In Sheffield, the two main teaching hospitals are the Royal Hallamshire Hospital and the Northern General Hospital, there is also St Luke’s Hospice. The Royal Hallamshire Hospital and the affiliated cancer centre, Western Park Hospital, are covered by a Hospital Support Team. Much experience is gained here in patient with very complex symptoms, including cancer patients undergoing treatment, haematology, neurology and gynaecology to name a few. There is also the opportunity to be involved in clinical trials. The Northern General Hospital has an 18 bedded NHS Funded Palliative Care Inpatient Unit as well as a Hospital Support Team, often the placement here will span these two services as well as having community input into the north of Sheffield. As part of the hospital support team, a range of patient with patients with different underlying diseases, including respiratory disease, renal and heart failure. In the south of Sheffield, is the second oldest 'modern' hospice in the country St Luke’s. This is a 30 bedded independent hospice, where the community services for Sheffield are also based. Like the inpatient unit at the Northern General Hospital admits patients primarily for complex symptom control or end of life care. There is also the opportunity to get involved with the management and strategy side here as well as teaching on the courses run by the hospice.
Chesterfield, just over 10 miles south of Sheffield, has a District General Hospital and independent hospice, both of which have trainees. These are the main centres offering palliative care in north Derbyshire and have a well established community team. The 18 bedded hospice admits patients with complex symptoms or end of life care, there is also a day centre requiring medical input. The community team is also based here. As part of the Hospital Support Team in the District General Hospital, a wide variety of patients are seen, and there is an interest in the management of patients with Cancer of Unknown Primary.
As well as being involved in palliative care clinics, throughout all of the hospital placements there is the opportunity to do non palliative specialist clinics, including chronic pain, heart failure and psychiatry.
Sheffield has a well established research department, based in the academic unit of supportive care in the University of Sheffield. There is the opportunity to spend one year doing research in the rotation.
There is half a day a week teaching, where both the underlying science and clinical aspects of symptoms are discussed as well other core curricular topics. There are also weekly journal clubs and case discussions as part of this.