Job description

Job responsibilities

Key Duties and Responsibilities

The Consultant Gynaecologist will provide consultant-led assessment, diagnosis, treatment and follow-up for patients with moderate to high-complexity benign gynaecological conditions suitable for management within a Tier 3 Community Gynaecology Service.

The post holder will:

• Assess and manage patients escalated from Tier 2 services due to persistent symptoms, treatment failure, abnormal investigation results or diagnostic uncertainty that remain suitable for ambulatory management.
• Provide specialist assessment and treatment for complex heavy menstrual bleeding and abnormal uterine bleeding, including the investigation and management of suspected fibroids, adenomyosis, endometrial polyps and other intrauterine pathology not meeting urgent cancer criteria.
• Deliver consultant-led outpatient hysteroscopy services, including endometrial biopsy and approved see-and-treat procedures such as selected polypectomy, resection or ablation of suitable intrauterine lesions where commissioned.
• Provide specialist menopause and hormone management services, including the assessment and treatment of premature ovarian insufficiency, early menopause, treatment-resistant menopausal symptoms and complex HRT management.
• Manage patients with persistent dysmenorrhoea, pelvic pain, dyspareunia and suspected endometriosis requiring consultant review and targeted investigation, where management remains appropriate within a community setting.
• Undertake specialist assessment and management of complex PCOS, amenorrhoea and endocrine-related gynaecological conditions, working collaboratively with endocrinology and fertility services where appropriate.
• Assess and manage severe or treatment-resistant PMS and PMDD, ensuring appropriate liaison with mental health and other specialist services where required.
• Provide specialist assessment of persistent benign vulval conditions and undertake vulval biopsy where clinically indicated and commissioned.
• Assess and manage patients with urinary incontinence and pelvic organ prolapse who have not responded to conservative management, including determining the need for further specialist intervention or surgery.
• Review and manage Trust waiting-list patients who have been pre-assessed as suitable for consultant-led ambulatory diagnostic and treatment pathways.
• Interpret diagnostic investigations, pathology and imaging results and formulate evidence-based management plans.
• Participate in multidisciplinary working, clinical governance, audit, service development and quality improvement activities.

Exclusions and Onward Referral

The Consultant Gynaecologist will ensure that patients whose clinical needs fall outside the commissioned Tier 3 Community Gynaecology Service are identified promptly and referred to the appropriate secondary, tertiary, urgent or specialist pathway. This includes:

• Suspected gynaecological cancer, postmenopausal bleeding requiring an urgent pathway, concerning pelvic or adnexal masses, ascites, or other urgent malignancy concerns.
• Emergency presentations including uncontrolled bleeding, severe anaemia or haemodynamic instability, acute abdomen, sepsis, pregnancy-related emergencies, or patients requiring same-day hospital assessment.
• Patients requiring major open, laparoscopic or complex hysteroscopic surgery, hysterectomy, pelvic floor surgery, inpatient admission or general anaesthesia outside the commissioned service model.
• Complex adnexal masses, deep infiltrating endometriosis, severe pelvic adhesions, fistulae, mesh complications or conditions requiring specialist multidisciplinary or tertiary care.
• Fertility treatment, recurrent miscarriage services, abortion or miscarriage management and obstetric care, unless separately commissioned.
• Complex colposcopy services or cervical dysplasia treatment outside the commissioned service scope.
• Patients requiring MRI, CT, urodynamic studies or other advanced diagnostics where no agreed pathway exists.
• Patients with significant anaesthetic, medical or safeguarding risks that make ambulatory assessment or treatment inappropriate.
• Cases requiring MDT review, persistent diagnostic uncertainty following Tier 3 assessment, pathology requiring specialist review, or findings that exceed the clinical or procedural scope of the service.
• Any patient who develops new red-flag symptoms or clinical deterioration during their care pathway requiring immediate escalation to an urgent, cancer or Tier 4 service.

Person Specification

Experience

Essential

• GMC registration with licence to practise
• Current GMC Specialist Registration or substantive experience working at SAS Grade level
• MRCOG or equivalent specialist qualification
• Significant experience in benign gynaecology
• Experience of ambulatory and outpatient procedures
• Strong clinical leadership and decision-making skills
• Commitment to patient-centred care and clinical excellence

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.

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

HealthHarmonie

Address

Abercromby Health Centre

Grove Street

Edge Hill

Liverpool

L7 7HG

United Kingdom

Employer's website

https://www.healthharmonie.com/ (Opens in a new tab)