All University Hospitals Bristol NHS Foundation Trust trainees will spend 3 months attached to the Bristol Haemophilia Centre which is based on level 3 of the Bristol Haematology and Oncology Centre within the University Hospitals Bristol. The aim is take trainees in the latter stages of their training prior to Part 2 of MRCPath.
The Centre is designated a Comprehensive Care Centre and covers a wide geographical area including Bristol, South Gloucestershire and North Somerset, with a wider tertiary service. The adult team comprises Dr Andrew Mumford Senior Lecturer and Centre Director, Dr Amanda Clark Consultant Haematologist and Training Programme Director, Emma Franklin and Michelle Horton Haemophilia Nurse Specialists,and Ann Thomas Specialist Haemophilia Physiotherapist. Emma Franklin is qualified as an independent prescriber. Within the laboratory Chris Reilly-Stitt and Davud Gurney provide expertise and are keen teachers. The Paediatric service is led by Dr Ollie Tunstall, there is a whole time equivalent Paediatric Haemophilia nurse specialist role shared by Anna Farrell and Caroline Robertsand specialist Haemophilia physiotherapy support from Hannah Harbridge. The adult and Paediatric Haemophilia Services are closely linked. Although there are no formal paediatric sessions during the attachment, there is exposure to laboratory aspects of Paediatric Haemostasis. All trainees will also undertake a period of training within the Paediatric Department when they will get additional clinical exposure.
We hold regular multidisciplinary review clinics for patients with severe Haemophilia, in addition to walk-in sessions. Trainees are encouraged to learn about the various issues pertinent to long term management of Haemophilia. We have a named Orthopaedic Surgeon and a named hepatologist with whom we run joint Orthopaedic and Hepatology clinics respectively.
For patients with milder bleeding disorders we have a highly successful nurse-led review system. Patients are offered either annual telephone reviews or review at the Centre, once diagnosis has been made and treatment plans have been outlined.
We have close links with gynaecology, obstetrics and fetal medicine to enable a coordinated approach to management of women with bleeding disorders and known carriers of Haemophilia.
Trainees are expected to be actively involved in planning elective procedures and managing emergencies, with close consultant supervision as required.
There is a regular weekly Haemostasis clinic attended by both Consultants and the Registrar. Trainees are first point of contact for ward referrals, thus gaining experience of acquired disorders of Haemostasis. We work with colleagues in the DVT services and anticoagulation services in an advisory capacity. There is a twice monthly combined obstetric haematology clinic
There are twice weekly meetings between Haemophilia Centre medical staff and the staff in the Haemostasis laboratory to discuss interesting and difficult cases. We perform a wide range of investigations in house and trainees are encouraged to spend time in the laboratory familiarising themselves with laboratory assays and techniques.
There are opportunities for enthusiastic trainees to be involved in small research projects and audit, with the aim of publication.
The Centre is building up a portfolio of clinical trials, and there are links with University of Bristol through Dr Mumford.
Experience in management will include general laboratory management and more specialised provision of Haemophilia services. Trainees will have the opportunity to attend management and finance meetings.