OXFORD DEANERY SPECIALTY TRAINING PROGRAMME
IN FORENSIC PSYCHIATRY
About Oxford Deanery
The Oxford Deanery covers the counties of Oxfordshire, Berkshire and
Buckinghamshire, with Banbury and Milton Keynes in the North, to Reading and
Slough in Berkshire and High Wycombe and Aylesbury in the West.
The Oxford Deanery is part of NHS South of England which comprises South
Central, South West and South East Coast Strategic Health Authorities. The Oxford
Deanery is responsible for the training of some 1500 trainees.
The Oxford Deanery is a relatively small deanery with a defined geographical area
which serves as a single unit of application. In the majority of cases successful
candidates will be asked to preference their choice of location for either one or two
years. Some programmes will require successful candidates to indicate a location
and specialty. Future placements will usually be based on individual training and
educational needs. Please note that applications are to the Oxford Deanery as a
whole. This may mean that you may be allocated to any geographic location
within the Oxford Deanery depending on training needs.
The Forensic Psychiatry Training Programme
The Forensic Psychiatry training programme is a 3 year programme, starting at ST4.
During this time, the trainee's work will be monitored for satisfactory progress and
subject to annual reviews in the form of ARCPs. Progression on the programme will
be dependent upon these reviews.
The posts on this rotation have been approved for Specialist Training by the Royal
College of Psychiatrists. The posts attract National Training Numbers and provide
training towards a Certificate of Completion of Training (CCT).
The Postgraduate Dean has confirmed that this post has the necessary educational
and staffing approvals.
The programme is based in several different Trusts throughout the Oxford Deanery
so trainees may find themselves employed by any of the following Trusts and placed
in any of the following hospitals:
Trusts
Oxford Health NHS Foundation Trust
http://www.oxfordhealth.nhs.uk/
Hospitals and Locations
Littlemore Mental Health Centre, Oxford
Marlborough House MSU, Milton Keynes
Rotation Information –
Rotations may at times change in response to clinical need from the Trusts. Expected
rotation arrangements for this programme are: every 12 months.
The Higher Training Scheme in Forensic Psychiatry is based at the Oxford Clinic Medium
Secure Unit, Littlemore Mental Health Centre, Oxford, and Marlborough House Medium Secure
Unit, Milton Keynes. In addition to the full-time specialist trainees in forensic psychiatry the peer
group may at any time include flexible trainees, general psychiatry StRs on a year’s
secondment to forensic psychiatry, or research fellows.
A wide and relevant training in forensic psychiatry is offered, including the therapeutic use of
containment, security and legislation. The medium-secure units have close links with other
services and specialties. Staff as well as patient and public safety has a high priority.
OXFORD HEALTH NHS FOUNDATION TRUST
Training within the Thames Valley Forensic Mental Health Service will occur at the following
sites:
MARLBOROUGH HOUSE, MILTON KEYNES
Supervising consultants: Dr Srinivasa Thirumalai
Marlborough House is located on Milton Keynes General Hospital campus. The General
Hospital opened in 1984. It is a modern, purpose-built in-patient Medium-Secure Unit which
opened in 1989, taking patients mostly from Milton Keynes, Buckinghamshire and Berkshire.
Currently there are twenty nine medium-secure beds.
The staff includes three consultant psychiatrists, one or two specialist trainees in forensic
psychiatry, one Core Trainee and one SAS psychiatrist. There are two forensic psychologists,
nursing staff, occupational therapists, a technical instructor and secretarial support.
There are links with Woodlands House, a low-secure forensic unit in Aylesbury.
THE OXFORD CLINIC, LITTLEMORE MENTAL HEALTH CENTRE
Supervising consultants: Dr Mark Hancock, Dr Susan Hardy, Dr Vivek Khosla, Dr Gautam
Gulati, Dr Sukhjeet Lally
Littlemore Mental Health Centre is one of the psychiatric hospitals within the Trust, and is
situated to the south of Oxford. The Oxford Clinic, a modern, purpose-built medium-secure unit
is situated within the grounds. The Clinic has fourteen acute and sixteen rehabilitation medium
secure beds. An adjacent, twenty-bed low-secure unit (Wenric House) and fifteen-bed predischarge unit (Lambourn House) is also part of the forensic services, as is a twenty four bed
enhanced low secure unit for female patients (Thames House).
Medical staff include eight consultant forensic psychiatrists, three to four full-time StRs in
forensic psychiatry, and two or three Core Trainees. The service is sectorized: Dr Lally, Dr
Gulati, and Dr Hardy cover Oxfordshire, Dr Hancock covers West Berkshire and Dr Khosla
covers East Berkshire. Other staff include clinical and forensic psychologists, occupational
therapists, ward-based and community psychiatric nurses and social workers linked to
community health teams, plus secretarial support.
Dr Lally is Clinical Director of Forensic & Secure Services.
There is an attached ten-bedded medium-secure unit for learning-disabled patients, which is
managed and staffed by a separate Learning Disability Trust. This service could be accessible
as a training experience for forensic StRs.
COMPONENTS OF FORENSIC TRAINING
The weekly timetable will be tailored to individual needs following a model of 8 clinical and 2
special interest or research sessions.
The overall training will consist of:
1.
The assessment, management, treatment and rehabilitation of patients in a
medium-secure unit
Specialist trainees work under supervision and attend clinical team meetings, management and
clinical reviews, and case conferences. They work closely with other disciplines and take a lead
in the planning and implementation of treatment programmes under supervision. They will
participate in the assessment of patients referred to the secure unit from elsewhere (eg prisons,
special hospitals and other psychiatric hospitals).
2.
Management of out-patients/liaison psychiatry and the Courts
Trainees accept tertiary referrals from general psychiatrists, and work closely with the Home
Office in the case of restricted patients, and with the probation service where patients are
subject to probation orders with a condition of psychiatric treatment. Referrals are also taken
from the Courts and solicitors. The forensic psychiatry out-patient service is often integrated
with the general psychiatry service, and there is an emphasis on good communication with other
professionals, including psychologists, probation officers, general psychiatrists, community
psychiatric nurses and social workers. Some clinics are held in outlying centres. Trainees are
supervised in the preparation of reports and as expert witnesses.
3
Prison experience
The forensic psychiatry service at the Oxford Clinic provides a visiting psychiatric service to
Bullingdon, Grendon and Huntercombe Prisons. The forensic psychiatry service at Marlborough
House provides a visiting psychiatric service to Woodhill and Aylesbury Prisons. The trainee
gains experience in the assessment, management and treatment of the mentally disordered in
prisons. All work is supervised by the appropriate consultant.
Trainees could have the option of gaining special experience at the HM Remand Centre in
Reading.
4.
High Security Hospital experience
Broadmoor Hospital provides training in the assessment, management and treatment of patients
detained under conditions of high security. At Broadmoor Hospital there is the opportunity to
work with a range of possible consultants on different units, depending on the trainee’s
particular interests. High Security Hospital experience is usually acquired by day release during
the integrated year of training, and the minimum requirement is currently 30 days.
5.
Psychotherapy
Trainees are encouraged to develop forensic psychotherapy skills. Psychotherapy supervision
for both individual and group work is available under the direction of Dr Steve Pearce in the
Department of Psychotherapy in Oxford, which also provides supervision for cognitive analytic
therapy.
6.
Research
Two sessions a week are allocated to either special interest or research. StRs have the
opportunity to undertake research under supervision, and prepare work for publication and
presentation at professional meetings. Links with the Oxford University Department of
Psychiatry in Oxford facilitate research development. Dr Seena Fazel, who has specific
academic sessions, will also assist in developing and supervising research.
7.
Forensic Academic/Teaching
One session per week during term time is allocated to the academic teaching programme. The
programme consists of clinical seminars, a journal club and academic presentations by invited
speakers. There is also a visits programme.
Attendance at relevant regional and national conferences and training events is facilitated as
appropriate. Good library facilities are available.
There are teaching opportunities (medical students and Core Trainees) via the University
Department of Psychiatry in Oxford, which organizes a programme for Core Trainees taking
Parts 1 and II of the examinations for membership of the Royal College of Psychiatrists. Other
teaching opportunities include approved social work training courses, workshops for probation
officers and nurses, and teaching ward-based junior doctors.
8.
Clinical Governance / Audit
Trainees are expected to take an active role in clinical audit and governance.
9.
Management experience
Management experience may be gained in the placements (eg, development and planning
committee work, shadowing, etc) and via approved courses. All StRs are expected to attend
management training workshops held within the Deanery, or equivalent events elsewhere.
10.
Supervision
Trainees have one hour per week of personal supervision with their trainer. Trainers combine
the roles of Clinical and Educational Supervisors for StR4-6’s. Each trainee is formally reviewed
at three monthly intervals.
11.
On-call
The StRs will participate in the General Senior Trainee rota. The on-call experience can include
out-of-hours assessments at police stations, domiciliary visits and casualty Mental Health Act
assessments. All such work is supervised by the duty Consultant General Adult Psychiatrist
and complies with the European Working Time Directive. Approval under Section 12 of the
Mental Health Act 1983 is highly desirable. Although there is no specific Forensic on-call rota
for StR’s, there are opportunities for those at ST6 level or above to gain experience shadowing
the Consultant Forensic Psychiatrist on-call.
CONSULTANT STAFF BASED IN THE FORENSIC MENTAL HEALTH SERVICE
Dr Srinivasa Thirumalai is Consultant Forensic Psychiatrist at Marlborough House MediumSecure Unit in Milton Keynes.
Dr Jonathan Shapero is Consultant Forensic Psychiatrist at Marlborough House MediumSecure Unit in Milton Keynes.
Dr Sophie Anwar is Consultant Forensic Psychiatrist at Marlborough House Medium-Secure
Unit in Milton Keynes and Woodlands House Low Secure Unit in Aylesbury.
Dr Sukhjeet Lally is Consultant Forensic Psychiatrist at the Oxford Clinic Medium-Secure Unit
in Oxford. His clinical catchment area is part of Oxfordshire. He is also the Clinical Director of
the service.
Dr Susan Hardy is Consultant Forensic Psychiatrist at the Oxford Clinic Medium-Secure Unit
in Oxford. Her clinical catchment area is part of Oxfordshire.
Dr Gautam Gulati is Consultant Forensic Psychiatrist at the Oxford Clinic Medium Secure Unit
in Oxford. His clinical catchment area is part of Oxfordshire.
Dr Mark Hancock is Consultant Forensic Psychiatrist at the Oxford Clinic Medium Secure Unit
in Oxford. His clinical catchment area is West Berkshire.
Dr Vivek Khosla is Consultant Forensic Psychiatrist at the Oxford Clinic Medium-Secure Unit.
His clinical catchment area is East Berkshire.
Dr Rami El-Shirbiny is Consultant Forensic Psychiatrist at the Thames House Enhanced Low
Secure Unit for females and Woodlands House Low Secure Unit in Aylesbury.
Dr Julia Cartwright is Consultant Forensic Psychiatrist at the Thames House Enhanced Low
Secure Unit for females.
Dr Seena Fazel is a Senior Lecturer in Forensic Psychiatry and Honorary Consultant Forensic
Psychiatrist, University of Oxford.
Candidates are encouraged to visit the Scheme by arrangement with the Programme Director:
Contact
Address
Dr V Khosla
Programme Director
The Oxford Clinic
Littlemore Mental Health Centre, Sandford
Road
Oxford OX4 4XN
Telephone
0845 219 1224
Main Conditions of Service
Appointments to this programme are subject to the Terms and Conditions of Service
(TCS) for Hospital Medical and Dental Staff (England and Wales). In addition
appointments are subject to:
 Applicants having the right to work and be a doctor or dentist in training in the
UK
 Registration with the General Medical Council
 Pre-employment checks carried out by the Trust HR department in line with
the NHS employment check standards, including CRB checks and
occupational health clearance.
The employing Trust’s offer of employment is expected to be on the following
nationally agreed terms:
Hours – The working hours for junior doctors in training are now 48-hours (or 52hours if working on a derogated rota) averaged over 26 weeks (six months). Doctors
in training also have an individual right to opt-out if they choose to do so, but they
cannot opt-out of rest break or leave requirements. However, the contracts for
doctors in training make clear that overall hours must not exceed 56 hours in a
week (New Deal Contract requirements) across all their employments and any
locum work they do.
http://www.nhsemployers.org/PlanningYourWorkforce/MedicalWorkforce/EWT
D/Pages/EWTD.aspx
Pay – you should be paid monthly at the rates set out in the national terms and
conditions of service for hospital medical and dental staff and doctors in public health
medicine and the community health service (England and Wales), “the TCS”, as
amended from time to time. The payscales are reviewed annually. Current rates of
pay may be viewed at
http://www.nhsemployers.org/PayAndContracts/Pay%20circulars/Pages/PayCircular
sMedicalandDental.aspx Part time posts will be paid pro-rata
Pay supplement –depending upon the working pattern and hours of duty you are
contracted to undertake by the employer you should be paid a monthly additional
pay supplement at the rates set out in paragraph 22 of the TCS. The current
payscales may be viewed at
http://www.nhsemployers.org/PayAndContracts/Pay%20circulars/Pages/PayCircular
sMedicalandDental.aspx . The pay supplement is not reckonable for NHS pension
purposes. The pay supplement will be determined by the employer and should be
made clear in their offer of employment and subject to monitoring.
Pension – you will be entitled to join or continue as a member of the NHS Pension
Scheme, subject to its terms and rules, which may be amended from time to time. If
you leave the programme for out of programme experience you may have a gap in
your pension contributions. More information can be found at
http://www.nhsbsa.nhs.uk/pensions
Annual Leave – your entitlement to annual leave will be five or six weeks per annum
depending on your previous service/incremental point, as set out in paragraphs 205-
206 of the TCS. The TCS may be viewed at
http://www.nhsemployers.org/PAYANDCONTRACTS/JUNIORDOCTORSDENTISTS
GPREG/Pages/DoctorsInTraining-JuniorDoctorsTermsAndConditions150908.aspx
Sick pay – entitlements are outlined in paragraph 225 of the TCS.
Notice –you will be required to give your employer and entitled to receive from them
notice in accordance with paragraphs 195-196 of the TCS.
Study Leave –the employer is expected to offer study leave in accordance with
paragraphs 250-254 of the TCS. Local policy and procedure will be explained at
induction.
Travel Expenses – the employer is expected to offer travel expenses in accordance
with paragraphs 277-308 of the TCS for journeys incurred in performing your duties.
Local policy and procedure should be explained at induction.
Subsistence expenses – the employer is expected to offer subsistence expenses in
accordance with paragraph 311 of the TCS. Local policy and procedure should be
explained at induction.
Relocation expenses – the employer will have a local policy for relocation expenses
based on paragraphs 314 – 315 of the TCS and national guidance at
http://www.nhsemployers.org/PAYANDCONTRACTS/JUNIORDOCTORSDENTISTS
GPREG/Pages/DoctorsInTraining-JuniorDoctorsTermsAndConditions150908.aspx.
You are advised to check eligibility and confirm any entitlement with the employer
before incurring any expenditure.
Pre-employment checks – all NHS employers are required to undertake preemployment checks. The employer will confirm their local arrangements, which are
expected to be in line with national guidance at
http://www.nhsemployers.org/RecruitmentAndRetention/Employmentchecks/Pages/Employment-checks.aspx
Professional registration – it will be a requirement of employment that you have
professional registration with the GMC/GDC for the duration of your employment.
Though the post is covered by NHS Indemnity, you are strongly advised to register
with the MPS for professional indemnity.
Health and Safety – all employers have a duty to protect their workers from harm.
You should be advised by the employer of local policies and procedures intended to
protect your health and safety and expected to comply with these.
Disciplinary and grievance procedures – the employer will have local policies and
procedures for dealing with any disciplinary concerns or grievances you may have.
They should advise you how to access these, not later than eight weeks after
commencement of employment.
Educational Supervisor – the employer or a nominated deputy (usually the Director
of Medical Education) will confirm your supervisor on commencement.
General information on the Deanery’s management of Specialty Training
programmes, including issues such as taking time out of programme and dealing
with concerns or complaints, is available at www.oxforddeanery.nhs.uk and in the
national ‘Gold guide’ to Specialty Training at http://www.mmc.nhs.uk Please ensure
that you inform Oxford Deanery of any changes to your contact details.