HEALTH EDUCATION THAMES VALLEY - SPECIALTY
TRAINING PROGRAMME IN ANAESTHESIA
About Oxford Deanery
We are the Local Education and Training Board (LETB) for Thames Valley covering
Berkshire, Buckinghamshire and Oxfordshire. Our vision is to ensure the delivery of
effective workforce planning and excellent education and training to develop a highly
capable, flexible and motivated workforce that delivers improvements in health for
the population of Thames Valley. Thames Valley LETB is responsible for the training
of some 1500 trainees
Health Education Thames Valley is a relatively small organisation 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
Health Education Thames Valley as a whole. This may mean that you may be
allocated to any geographic location within the deanery depending on training
needs.
The Anaesthetic Training Programme
The Anaesthetic training programme is a 5 year programme, starting at ST3. 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 Anaesthetists. 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.
Further information on the Health Education Thames Valley Anaesthetics Specialty
Training Programme can be found on the School website:
http://sites.google.com/site/oxfordanaesthesiaschool/home
The programme is based in several different Trusts throughout Health Education
Thames Valley so trainees may find themselves employed by any of the following
Trusts and placed in any of the following hospitals:
Trust
Oxford University Hospitals
NHS Trust
Hospitals and Locations
John Radcliffe Hospital, Headington, Oxford
http://www.ouh.nhs.uk/
Churchill Hospital, Headington, Oxford
http://www.ouh.nhs.uk/
Nuffield Orthopaedic Centre, Headington, Oxford
Heatherwood and Wexham
Park Hospitals NHS
Foundation Trust
Royal Berkshire NHS
Foundation Trust
Buckinghamshire
Healthcare NHS Trust
http://www.ouh.nhs.uk/
Wexham Park Hospital, Slough
http://www.heatherwoodandwexham.nhs.uk/location/wexhampark-hospital-slough
Royal Berkshire Hospital, Reading
http://www.royalberkshire.nhs.uk/
Stoke Mandeville, Aylesbury
http://www.buckshealthcare.nhs.uk/
Wycombe Hospital, High Wycombe
http://www.buckshealthcare.nhs.uk/
Great Western Hospitals
NHS Foundation Trust
Great Western Hospital, Swindon
http://www.swindon-marlborough.nhs.uk/
Milton Keynes Hospital NHS
Foundation Trust
Milton Keynes General Hospital
http://www.mkgeneral.nhs.uk/
Rotation Information
Expected rotation arrangements for this programme are:
 ST3 year is spent at the John Radcliffe Hospital
 ST4 and ST5 are spent in a DGH
 ST6 and ST7 are spent at the John Radcliffe Hospital
However, this can change depending on the needs of the trainees and the training
programme.
Trust Information
Oxford University Hospitals NHS Trust
Nuffield Department of Anaesthetics
The Nuffield Department of Anaesthetics comprises closely associated University
and NHS departments, and is one of the largest anaesthetic departments in the
country. The Nuffield Department provides anaesthetic and critical care services to
all of the Oxford Hospitals.
The John Radcliffe Hospital is the principal teaching hospital with a main complex of
10 operating theatres and adjacent recovery and critical care areas, including the
Adult and Paediatric Intensive Care Units and the Cardiothoracic Critical Care Unit.
The Emergency Medicine Department and Trauma Service are also based here. The
Women's Centre at the John Radcliffe has 2 Gynaecology theatres and 3 Obstetric
theatres, and there are over 6500 deliveries per year. Neurosciences, ENT, plastic
and craniofacial surgery and the Oxford Eye Hospital have now moved from the
Radcliffe Infirmary to the new purpose built West Wing. The West Wing has 14
operating theatres and the Neurosciences Intensive Care Unit. The new purpose
built Children's Hospital is also on the John Radcliffe site, and the Oxford Heart
Centre opened in 2009.
The Churchill Hospital has 10 operating theatres, the Churchill Intensive Care Unit,
the Renal and Chest Units, and the new Cancer Centre which opened in 2009.
Current specialties include gynae-oncology, urology, transplant, breast cancer,
upper/lower GI and bariatric surgery, and radiotherapy. The Pain Relief Unit is also
based at the Churchill Hospital.
The Nuffield Orthopaedic Centre has 6 theatres for elective orthopaedic surgery, the
Bone Infection Unit and Bone Tumour Service.
Royal Berkshire Hospital
Trust: Royal Berkshire NHS Foundation Trust
The Royal Berkshire Hospital is a busy district general hospital (32,000 surgical
cases per year), which provides all services other than cardio-thoracic,
neurosurgical, plastic and major neonatal surgery.
All the surgical specialties at Reading carry out major cases within their field in
addition to the routine work e.g. major head and neck work in ENT. The General
surgeons perform major vascular and gastrointestinal work including
oesophagectomies and laparoscopic assisted colectomies. The orthopaedic
consultants do major back surgery, tertiary shoulder surgery, and revision
arthroplasty as well as general orthopaedics. The urology department regularly
perform laparoscopic nephrectomies, prostatectomies and cystectomies using
robotic assistance as well as open procedures. There is ample opportunity to
increase exposure to paediatric practice. The hospital has 2 spiral CT and 2 MRI
scanners with regular opportunities to anaesthetise in these environments.
The anaesthetic equipment is of a very high standard and fully complies with minimal
monitoring standards, it is undergoing a staged upgrade. We have a tradition of
allowing anaesthetists free choice in the techniques they can use and have
equipment to support the use of Total Intravenous Anaesthesia and Low Flow
Desflurane techniques. There is a core group of consultants enthusiastic to teach
upper limb regional blocks. A dedicated emergency theatre is available 24 hours a
day and every effort is made to ensure that all emergency work and non-elective
work is completed by 22.00 hrs in keeping with CEPOD recommendations.
The purpose built ICU has 11 beds and cares for 700 patients annually (8%
paediatric). The unit is supported by a highly motivated nursing team, and has been
involved in multi-centre research trials. Since 1999 it has had a computerised Clinical
Information System. Continuous cardiac output monitoring, haemofiltration,
percutaneous tracheostomy and intracranial pressure monitoring are all standard
procedures. Transoesophageal and transthoracic echocardiography is being
developed. It is one of the few ICUs in the UK to run a successful follow-up
programme. A 24 hour Outreach service has been developed over the last few
years. A separate consultant on call rota covers the unit and trainees do a threemonth ICU attachment. There is a senior joint CCT post in Intensive Care that
rotates with John Radcliffe.
There is a Pain management unit in purpose built area. There are three consultants
and two full time nurses with an interest in pain management. The unit offers a wide
range of invasive, drug based and pain management therapies. We have introduced
an Advanced Training Module in Pain for senior trainees. All other our trainees have
the opportunity to have a dedicated attachment in pain to cover specific topics, gain
competencies and to give them an opportunity to see what it involves as a
subspecialty.
The obssp;
We are EWTD (Aug 2009) compliant with a 1:8 on-call rota. Each trainee is allocated
an Educational Supervisor, signs an Educational Contract and develops a personal
development plan. There is weekly viva practice, weekly FRCA based teaching and
Post-Fellowship Management/Career Development Study Days four times a year as
well as opportunities to deliver teaching/viva practice. A new Simulation Centre
opened in November 2009 featuring SimMan 3G, SimNewB and SimBaby. This will
be a multidisciplinary facility with access for anaesthetic trainees.
We are lucky that we have been able to develop a team of high calibre clinical
anaesthetists with a variety of different special interests as well as styles. Some of
the consultants have a high profile either politically, within management or specialist
anaesthetic associations. We have a group of keen consultants who are particularly
involved in teaching, training, help with examinations and career progression of
trainees.
Over the last few years we have introduced consultant appraisal by trainees and are
pleased to say that the feedback has been very positive in the main. We have
achieved a very impressive success rate at the primary and final examinations. Year
on year our trainee satisfaction recorded by PHEEM feedback shows that trainees
look upon the Royal Berkshire as a good place to train.
Milton Keynes Hospital
Trust: Milton Keynes General Hospital NHS Trust
Anaesthetic Dept Website: www.mkdeptanaesthetics.com
Milton Keynes General Phase I opened in April 1984 and contained 361 beds and 4
operating theatres. Phase II, commissioned in 1991, comprised 188 beds – only a
portion of these Phase II beds are currently open but the final bed complement will
be 529. There are two theatre blocks totaling 8 working theatres, together with a
treatment and diagnostic unit, which increases the total number of theatres to 12.
The hospital has a 9 bed Critical Care Unit offering invasive and non-invasive
ventilation, intracranial pressure monitoring, haemofiltration and invasive cardiac
monitoring.
Specialities covered include: general surgery, trauma and orthopaedics, urology,
ENT, ophthalmic, vascular, emergency medicine, obstetrics and gynaecology and
paediatric and day surgery. The obstetric unit covers approximately 3000 deliveries
per year, there is a 24 hour epidural service and twice-weekly elective caesarean
section lists. The hospital also has a chronic pain relief unit, CT scanning unit,
community dental clinic, pathology and x-ray, the latter containing a fixed MRI
scanner which is one of the most advanced in the UK. The hospital is in the forefront
of IT with the facility to view x-ray digitally in current use and the impending launch of
the new CRS system.
Buckinghamshire Hospitals
Trust: Buckinghamshire Hospitals NHS Trust
Stoke Mandeville Hospital
We are a District General Hospital with a difference! We do all the emergency
surgery for Buckinghamshire Hospitals except for Vascular and some Obstetric and
Gynae emergencies. We also house the National Spinal Injuries Centre and do
elective and emergency Spinal Surgery. There is a sub-regional Burns/Plastics Unit
on site and a large (2 dedicated operating theatres) Ophthalmic Unit. Our work is
complementary to Wycombe hospital which does the major part of elective general
and orthopaedic surgery.
Wycombe General Hospital
Wycombe Hospital is a busy town centre general hospital. It offers a wide range of
acute hospital services including 24 hour Accident and Emergency (non-surgical),
Critical Care, Elective General Surgery, General Medicine, Elective Trauma and
Orthopaedic Surgery and Women's and Children's Services. The hospital provides
a specialist centre for Urology. Vascular Surgery and Heart Investigative Services
are also based on this site.
Wycombe Hospital has undergone a £40m PFI improvement scheme and is now
home to the Buckinghamshire NHS Trust Specialist Surgical Centre. The Centre is
a dedicated facility for all routine general surgical, urological and orthopaedic
operations that may require a stay of one or more nights.
Wexham Park and Heatherwood Hospital
Trust: Heatherwood and Wexham Park Hospitals NHS Trust
Wexham Park Hospital, Slough, the principal hospital in the Trust, is a busy District
General Hospital. It provides services for acute medicine and surgery, emergency
medicine, ENT, gynaecology, haematology, obstetrics, orthopaedics and trauma,
plastic surgery, psychiatry and urology. There is a new theatre block at Wexham
Park with 9 state of the art theatres including 3 with Laminar Flow. This theatre block
also houses seminar rooms with extensive teaching facilities for presentations. There
is a new 12 bedded ITU/HDU close to the theatre suite which has full time dedicated
consultant cover. There is also an active invasive cardiology unit undertaking
angiography, permanent pacemakers and implantable defibrillators. There will soon
be an angioplasty service. The Obstetric Unit has 4000 deliveries per year.
Heatherwood Hospital, Ascot provides services for elective orthopaedics, urology,
general and day-care surgery and a low risk Obstetric Unit. There is also a Chronic
Pain Clinic and services are provided for acute medicine and psychiatry.
Heatherwood Hospital has a suite of 5 operating theatres with two dedicated to
orthopaedics and one to day-case surgery. The obstetric theatre is within the
Delivery Suite. All emergency anaesthetics at Heatherwood Hospital are provided by
career grade anaesthetists.
King Edward VII Hospital, Windsor is purely an Ophthalmological Centre as far as
the provision of anaesthetic services is concerned.
In total there are 94 operating lists including 10 emergency lists, 8 opthalmic lists, 2
community dental lists, 4 ECT sessions, 1 paediatric oncology session, 1 paediatric
MRI session and 7 chronic pain relief sessions.
There is an active teaching programme and excellent facilities at the Post Graduate
Medical Education Centre.
The Great Western Hospital
Trust: Swindon and Marlborough NHS Trust
The Great Western Hospital is a large District General Hospital, the Department
provides Anaesthesia for Ophthalmic, ENT, Oral, Orthopaedic, Emergency Medicine,
Gynaecology, General, Urological and Vascular Surgery. There are 15 operating
theatres all equipped with modern anaesthetic machines and full monitoring
equipment.
The Obstetric Unit is housed one floor above main theatres. There is a Delivery Suite
with integral operating theatre. A Special Care Baby Unit is nearby. A 24-hour
epidural service is provided with 11 dedicated anaesthetic sessions to the Delivery
Suite per week. A regular antenatal anaesthetic assessment clinic is held fortnightly.
The Pain Clinic offers an outpatient service for chronic pain sufferers. Four sessions
per week are devoted to this. A Pain Management Programme which runs in
conjunction with colleagues from Clinical Physiology, Occupational Health and
Physiotherapy, takes place twice a year. There is an Acute Pain Team, led by Dr
Baigel with four nursing sisters.
An Anaesthetic Pre-assesment Clinic led by Dr Clare van Hamel is run daily to see
patients with potential anaesthetic problems.
Teaching

All Trusts have regular teaching programmes
Duties of Post

Clinical, teaching, audit/research
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 205206 of the TCS. The TCS may be viewed at
http://www.nhsemployers.org/PayAndContracts/MedicalandDentalContracts/JuniorD
octorsDentistsGPReg/Pages/DoctorsInTrainingJuniorDoctorsTermsAndConditions150908.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/MedicalandDentalContracts/JuniorD
octorsDentistsGPReg/Pages/DoctorsInTrainingJuniorDoctorsTermsAndConditions150908.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 LETB’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://specialtytraining.hee.nhs.uk/.
Please ensure that you inform Health Education Thames Valley of any changes to
your contact details.
September 2013