To participate in the provision of a comprehensive diagnostic neuropathology and muscle pathology service to Bristol foundation and to a few external organisations including other healthcare trusts, and some coronial and criminal investigation services.
The post-holder will be expected to rotate through the various sections of the Laboratory (biopsy & autopsy, immunohistochemistry; enzyme histochemistry;). The role requires working hours between 9.00am and 5.15pm, with occasional flexibility required to meet service needs.
Neuropathology resides within the Cellular Pathology department, and the post may be required to work within Histology increasingly overtime. Appropriate training will be provided to enable post holders to develop the necessary competencies to fulfil the requirements of the role
Paraffin wax histology of surgical biopsies -
Assisting a pathologist with specimen cut-up
Processing and embedding specimens into wax
Microtomy of wax blocks using a rotary microtome to produce sections for mounting on slides
Staining of these slides by a range of dye methods to demonstrate specific tissue components
Paraffin wax histology of autopsy specimens to include -
Processing and embedding large specimens into wax
Microtomy of large dimension wax blocks using a rotary microtome to produce sections for mounting on large format slides
o Urgent interoperative diagnostic methods -
Staining of biopsy tissue smears for inter-operative diagnosis
Freezing and cutting sections of these frozen blocks of biopsy tissue using a cryostat. These sections are mounted on slides and stained.
o Enzyme histochemistry of muscle biopsies -
Dissection, sampling and rapid freezing of specimens using iso-pentane cooled in liquid nitrogen
Using a cryostat to cut sections of the frozen muscle for mounting on glass slides
Performing a range of enzyme histochemical incubations on mounted sections of the specimen to demonstrate the pattern of activity of these enzymes in the muscle tissue
o Immunohistochemistry - Application of immunohistochemistry techniques to both wax-embedded and frozen tissue samples.
Cytology methods -
Preparation of slides containing cells extracted from cerebral spinal fluid suspensions using a cytocentrifugation technique;
Staining of these slides for microscopy
Bristol NHS Foundation Trust brings together more than 28,000 staff to deliver over 160 clinical services across thirteen hospital locations, operating from three main sites at Southmead, Bristol city centre and Weston.
With an annual turnover of 2.6 billion, we are now one of the largest NHS trusts in the United Kingdom.
Chaired by Ingrid Barker and led by Maria Kane as Chief Executive, Bristol NHS Foundation Trust aims to transform the way healthcare is delivered locally with a clear focus on making a difference for what we call our Four Ps:
Better outcomes for our Patients
More opportunities for our People
Fairer more consistent care for our Population
Best Value for Public Purse
Our vision for five years from now:
Patients will wait less time to be diagnosed and treated, and they will have the same high-quality experience and outcomes, regardless of who they are or where they live.
We will meet rising demand by maximising the use of our available resources.
More care will be delivered nearer to patients, in their homes or the community.
Digital technologies will have transformed the way we work and the way we deliver care.
Our people will feel engaged, energised and empowered by their work.
We will be known as a place where people enjoy working, training and building a career.
Our volume of globally renowned research and innovation will have grown significantly.
We will contribute to system financial balance
1. Scientific / technical:
- To participate in the reception, preparation, documentation and subsequent safe disposal of all specimens
- To adhere to and assist in ensuring ongoing accuracy of established protocols and procedures ensuring that:
o There is consistency in the preparation of laboratory specimens
o Equipment safety and maintenance schedules are followed
o Health and safety standards are met
o Appropriate records are maintained (in both electronic and written formats)
- To assist in investigation into laboratory incidents and other aspects of ensuring ongoing quality such as auditing following appropriate training
- To ensure completion of appropriate training and maintenance of competency, escalating any training needs
- To rotate through all sections of the department, participating in the duties indicated in the following paragraphs
o Paraffin wax histology of surgical biopsies -
Assisting a pathologist with specimen cut-up
Processing and embedding specimens into wax
Microtomy of wax blocks using a rotary microtome to produce sections for mounting on slides
Staining of these slides by a range of dye methods to demonstrate specific tissue components
o Identifying and assessing control material for use with the department’s panel of special stains
o Paraffin wax histology of autopsy specimens to include -
Processing and embedding large specimens into wax
Microtomy of large dimension wax blocks using a rotary microtome to produce sections for mounting on large format slides
Staining of these slides by a range of dye methods to demonstrate specific tissue components
Using various specialised silver impregnation techniques to demonstrate morphological features specific to the nervous system
o Urgent interoperative diagnostic methods -
Staining of biopsy tissue smears for inter-operative diagnosis
Freezing and cutting sections of these frozen blocks of biopsy tissue using a cryostat. These sections are mounted on slides and stained.
o Enzyme histochemistry of muscle biopsies -
Dissection, sampling and rapid freezing of specimens using iso-pentane cooled in liquid nitrogen
Using a cryostat to cut sections of the frozen muscle for mounting on glass slides
Performing a range of enzyme histochemical incubations on mounted sections of the specimen to demonstrate the pattern of activity of these enzymes in the muscle tissue
o Immunohistochemistry - Application of immunohistochemistry techniques to both wax-embedded and frozen tissue samples. Use of appropriate pre-treatment methods on slides prior to incubation. Application of automated techniques to demonstrate a wide spectrum of tissue components (currently utilising approximately 100 different antibody markers). Assistance with the validation and verification of reagents and methods to ensure optimal sensitivity and performance. Identification and assessment of suitable control material for use with the department’s panel of primary antibodies.
o Cytology methods -
Preparation of slides containing cells extracted from cerebral spinal fluid suspensions using a cytocentrifugation technique;
Staining of these slides for microscopy
- In addition, the post-holder may be required to provide occasional technical support for some departmental research activities
2. Service support:
- To assist in implementing both internal QC and external QA activities
- To assist in the day-to-day maintenance of the department’s facilities, to include:
o Preparation of reagents
o Filing of specimens and slides
o Cleaning & preparation of glassware and other lab materials
o Equipment maintenance
o Stock control
- To assist in training and supervising more junior staff within this Department
3. Communications:
The post-holder is required to communicate biomedical information of varying degrees of complexity with medical, scientific and secretarial staff within the Cellular Pathology Department, and in other departments both within and outside of the Bristol NHS Foundation Trust. This involves providing and receiving information both verbally and in writing
4. Other duties:
The post-holder may be required to undertake additional duties commensurate with the grade of post, and in the event of staff absence, may be required to cover for both higher and subordinate grades within the Cellular Pathology Department
Working Conditions / Effort
Physical demands involve for considerable periods during each working day the use of: IT workstations; microscopes; and laboratory equipment requiring continual repetitive movements (e.g. microtomes to cut sections of pathological specimens)
A moderate level of concentration is required to ensure accuracy and consistency in the documenting, preparation and labelling of pathological specimens. Higher concentration levels are necessary when checking and assessing specimens
A range of pathological specimens are received and processed in the department daily, including:
Both fresh and formalin-fixed samples of tissue biopsied during surgery
Unfixed and formalin-fixed complete brains and spinal cords removed during autopsy
There is regular handing of hazardous chemicals under controlled conditions and of pathological specimens under appropriate levels of containment. The greatest risk is presented by spongiform encephalopathy cases such as CJD and variant CJD in which the infective prion protein is not denatured by routine specimen fixation procedures
There is a requirement to wear protective clothing and apparatus. In addition to wearing laboratory coats, protective gloves are used regularly. Goggles, face-masks and chain-mail gloves are also used as necessary
Some routinely performed techniques require the use of cryogenic agents, which are dispensed and handled with appropriate protection:
Liquid nitrogen (-190°C), is used in the rapid freezing of muscle specimens
’Cryospray’ (-52°C) is used to freeze small biopsy specimens for sectioning in a cryostat
Many specimens are stored in a deep freeze at -80°C
Knowledge, Training, Experience and Skills Required
Knowledge, Training, Experience and Skills required
1. Biomedical Sciences qualification at degree level or equivalent
2. State registration with the Health and Care Professions Council is essential
3. Basic theoretical knowledge of the core laboratory techniques used in neuropathology and muscle pathology diagnostic investigations, especially:
3.1. Paraffin wax histology
3.2. Immunohistochemistry
3.3. Enzyme histochemistry
3.4. CSF cytology
4. Practical competence in applying the above techniques to the investigation of diseases of the nervous system and muscle
5. Knowledge and experience of using databases and other office applications running on a Microsoft Windows network
6. Knowledge of, and training in, basic laboratory Health and Safety procedures
7. Evidence of involvement in biomedical sciences Continuing Professional Development activities
8. An aptitude for perfoming the various technical laboratory processes used within this Department
9. The ability to work reliably following the Department’s operating procedures and policies - attention to detail is an essential requisite for all laboratory procedures
10. A high level of concentration to enable complex procedures to be completed in a timely and accurate manner
11. Good eye-hand coordination is required for many techniques involving small specimens
12. Well-developed organisational skills enabling one’s workload to be planned efficiently, and for various laboratory procedures to be performed in parallel
13. The ability and confidence to work both independently and as part of a small team
14. Proven analytical skills, especially in quality control and trouble-shooting basic laboratory procedures
15. Good interpersonal and communication skills (verbal & written) to facilitate effective working relationships with all groups of staff, both within and outside of the Department
16. The ability to communicate and discuss complex and sensitive information, when appropriate, with staff of all grades
