HEALTH EDUCATION THAMES VALLEY - SPECIALTY
TRAINING PROGRAMME IN NEUROLOGY
About Health Education Thames Valley
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 around 2000 Foundation and Specialty 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 Neurology Training Programme
The Neurology training programme is typically 5 years in duration, 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 Physicians. The post attracts a National Training Number and provides
training towards a Certificate of Completion of Training (CCT) in Neurology.
The Postgraduate Dean has confirmed that the post has the necessary educational
and staffing approvals.
The Neurology programme is based at the John Radcliffe Hospital in Oxford, but
may include attachments at Northampton General Hospital, The Royal Berkshire
Hospital in Reading, Milton Keynes Hospital and the National Hospital for Neurology
and Neurosurgery, London.
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
Hospitals and Locations
Oxford University Hospitals NHS
Trust
Royal Berkshire NHS Foundation
Trust
John Radcliffe, Oxford
http://www.ouh.nhs.uk/
Royal Berkshire Hospital, Reading
http://www.royalberkshire.nhs.uk/
Northampton General Hospital Trust
Northampton General Hospital
http://www.northamptongeneral.nhs.uk/Home.aspx
Milton Keynes Hospital NHS
Foundation Trust
University College London Hospitals
NHS Foundation Trust
Milton Keynes General Hospital
http://www.mkgeneral.nhs.uk/
The National Hospital for Neurology and
Neurosurgery, London http://www.uclh.nhs.uk/
Rotation Information
Rotations may at times change in response to clinical need from the Trusts.
Expected rotation arrangements for this programme are set out below.
In line with the Neurology curriculum 2010 the training period is typically 5 years. An
appropriate period of research may be recognised towards training and a trainee
might then spend 4 years in the various posts of the program. Two 4 year rotations
are given below by way of illustration The order and duration of posts may vary.
Year
1
2
3
4
First 4 months
Neurology JRH –
Neuroscience Ward
firm A
Neurology JRH –
Neuroscience Ward
firm B
Neurology JRH –
Liaison Post
Neurology NHNN –
Firm E
Second 4 Months
Neurology DGH1
Third 4 Months
Neurology DGH1
Neurology DGH2
Neurology JRH –
Neuroscience
Ward firm C
Neurology DGH3
Neurology JRH –
Neuroscience Ward
firm D
Neurology NHNN –
Firm F
Neurology JRH –
Neuroscience
Ward Firm
A/B/C/D
Year
1
2
3
4
First 4 months
Neurology JRH –
Neuroscience Ward
firm A
Neurology JRH –
Neuroscience Ward
firm B
Neurology JRH –
Liaison Post
Neurology JRH –
Neuroscience Ward
firm D
Second 4 Months
Neurology DGH1
Third 4 Months
Neurology DGH1
Neurology DGH2
Neurology DGH2
Neurology JRH –
Neuroscience Ward
firm C
Neurology JRH –
Neuroscience Ward
firm D
Neurology DGH3
Opportunity to
arrange OOPT
Trust Information
Oxford University Hospitals NHS Trust
The Oxford University Hospitals Trust (ORH) is one of the largest teaching trusts in
the country, with a national and international reputation for its services and its role in
teaching and research. It employs around 10,000 staff, and has an annual turnover
of over £600 million. It provides a district general hospital service for approximately
700,000 people in Oxfordshire and the neighbouring counties. With in excess of
1200 staffed beds, the Trust’s specialist services serve a population of circa 2.5
million in Oxfordshire, Buckinghamshire, Berkshire, Wiltshire, Gloucestershire and
Northamptonshire. In addition to the normal range of specialist services, the Trust
also provides other highly specialised treatment and care for a still wider catchment
area.
In 2008/9, there were:
 609,656 outpatient appointments
 117,922 attendances at the emergency departments
 86,725 admissions for emergency assessment and treatment
 64,816 admissions for treatment as day cases
 22,826 admissions for treated as inpatients
 8,722 babies delivered
The Trust works in close co-operation with the University of Oxford, and is a leading
centre for research programmes in cancer, neurosciences, diabetes, genetics and
many other fields. In 2007, the Trust, jointly with the University of Oxford, was given
the status of a Biomedical Research Centre by the Department of Health, making it
one of the five pre-eminent centres in the country for translational medical research.
The West Wing of the John Radcliffe Hospital opened in 2007 and houses the
neuroscience disciplines of Neurology, Neurophysiology, Neurosurgery,
Neuroradiology, Neuropathology, Neuropsychology and Neurocritical Care. The
Rehabilitation Service is at the Nuffield Orthopaedic Centre in Oxford.
Neurology at the OUH NHS Trust:
Consultants:
Prof C Kennard
Professor
Oxford
Prof G Ebers
Professor
Oxford
Prof P Rothwell
Professor
Oxford
Prof K Talbot
Professor
Oxford
Prof P Brown
Professor
Oxford
Dr M Turner
Clinician Scientist Oxford
Dr Z Cader
Clinician Scientist Oxford
Dr C Buckley
Clinician Scientist Oxford
Dr U Schulz
Clinician Scientist Oxford
Dr J Adcock
NHS
Oxford/Banbury
Dr A Parry
NHS
Oxford
Dr J Palace
NHS
Oxford/Banbury
Dr D Briley
NHS
Aylesbury/Oxford
Dr M Jackson
NHS
High Wycombe/Oxford
Dr S Wimalaratna
NHS
Kettering/Oxford
Other consultants, listed below, work in Oxford and Reading/Northampton/Milton
Keynes.
The trainee doctors working in neurology consist of the 4 Neuroscience ward based
and one JRH based liaison neurology registrar as well as 7 Neuroscience ward
SHOs (F2/CT1/CT2).
The Regional Neurological Service at the JRH comprises the NHS consultants
(predominantly Oxford or District Hospital based) and the University Department of
Clinical Neurology. These departments are closely integrated. The service
encompasses a wide range of sub-specialities including cerebrovascular disease,
dementia, headache, movement disorders (including a joint movement disorder
surgery team), epilepsy (including a joint epilepsy surgery team), peripheral
neuropathy, myasthenia gravis, muscle diseases, and multiple sclerosis. The service
includes nationally commissioned (NSCAG) services for congenital myasthenia,
neurofibromatosis II and neuromyelitis optica. Within the Department there are
currently 24 beds, with a further 12 being available on a day-case basis.
There is extensive neuroscience research activity within the NHS and University
Department and this includes functional MRI, a neuroscience group investigating ionchannel immunology and molecular genetics, neuropathological research, a stroke
group, a collaborative muscle group, MS and epilepsy research and a major recently
established Parkinson’s disease research programme. Additionally many
interactions exist between other university department and clinical groups within and
outside Oxford.
The Neurology trainee posts:
The consultants are currently organised into firms each with a specialty trainee. The
time tables for each post include 2 general neurology clinics and subspecialty clinics.
A further specialty trainee works with the consultants to provide a neurology liaison
service to the acute medical patients at the JRH and a neurological consulting
service to the rest of the hospital and the other hospitals in the trust.
Northampton General Hospital Trust
Northampton General Hospital NHS Trust is a large (750 beds) district hospital
providing a full range of acute services. The hospital serves a population of 380,000
centred on Northampton but including a mixture of rural and urban areas. In addition
to all the secondary care services normally found in a district general hospital,
including emergency care, planned care, maternity care, diagnostic and therapy
services, the trust provides specialised services for a wider population including a
hyperacute stroke service, designated regional cancer services, interventional
cardiology, renal medicine and plastic surgery.
Neurology
Consultants
Dr P T G Davies
Dr K Nithi
NHS
NHS
Northampton/Oxford
Northampton
The neurology and neurophysiology services at NGH provide most of the outpatient
neurological service for Northamptonshire as well as support for neurological
inpatients at NGH. About 1,500 new and 2000 follow up neurology patients (and over
3000 new neurophysiology patients) are seen in clinic each year.
The registrar programme at NGH runs from Monday to Thursday and is designed to
be flexible and to meet the needs of the trainee. Fixed sessions include one new and
one follow up neurology clinic a week, regular ward referrals (averaging 8 per week),
a medical student teaching session and a weekly grand round (neurology is on the
case presentation/image of the week rota). Neurophysiology training is flexible and
can be extensive if required (There are two consultant clinical neurophysiologists
and 3 qualified technicians). Other flexible experience includes excellent stroke
facilities run through the stroke physicians (including thrombolysis),
neurorehabilitation, botox clinics, first fit clinics, and headache clinics.
Royal Berkshire NHS Foundation Trust
The Royal Berkshire Hospital serves people across the West of Berkshire and South
Oxfordshire; a population of about 550,000. The Hospital has 650 beds and
provides services on a single site for all the major specialities including Accident and
Emergency, Trauma and Orthopaedics, Intensive Care, Gynaecology and
Obstetrics, Genitourinary Medicine, Ophthalmology, ENT, paediatrics (including a
NICU), general medicine (including all major medical specialities including CCU,
renal unit, 11 bed ITU and gastroenterology), radiotherapy and oncology, and all the
general surgical specialities. Comprehensive pathology services are available. The
hospital has recently been designated a hyperacute stroke centre.
Consultants:
Dr R Armstrong
Dr M Bogdanovic
Dr E Flossmann
NHS
NHS
NHS
Reading/Oxford
Reading/Oxford
Reading/Oxford
Dr A Weir
NHS
Reading/Oxford
Associate specialist:
Dr S Khan
Specialty trainee in Stroke medicine (rotation with JRH).
The Neurology team works in close liaison with two Neurorehabilitation consultants
and two Stroke physicians. There are 16 Neurorehabilitation beds, and a 28 bed
Stroke Unit. There is a weekly Botulinum Toxin clinic and weekly Neurophysiology
clinic. Specialist nurses provide weekly Parkinson’s disease, Multiple Sclerosis and
Motor Neurone Disease clinics. There are two Stroke Specialist Nurses. The
consultant neurologists provide a weekly acute neurology referral service (one in
four) and provide stroke thrombolysis (currently Monday-Friday). A weekly
multidisciplinary meeting is held with the Neurorehabilitation consultants and
paramedical staff. There is a weekly radiology meeting when all imaging is reviewed
in the Radiology department. There is a daily rapid access TIA clinic. There are two
MRI scanners and two CT scanners. There is a monthly neuro-opthalmology clinic.
There is a weekly grand round to which neurology contributes.
The neurology specialty trainee works Mon-Thur in Reading; they takes part in a
neurorehabilitation and two general neurology clinics each week. They work with the
consultants to provide a liaison neurology service and in particular rapid neurological
opinions for patients admitted to the Clinical Decision Unit. They are part of the
thrombolysis team and work with the stroke specialty trainee on the stroke unit.
Milton Keynes Hospital NHS Foundation Trust
Milton Keynes Hospital is a medium size hospital serving the over 300,000 people
living in Milton Keynes and the surrounding areas. The hospital has approximately
500 inpatient beds and provides a broad range of general medical and surgical
services, including A&E, for over 300,000 people every year.
Consultants:
Dr D Hilton-Jones
Dr R Butterworth
Dr M Hu
NHS
NHS
NHS
Milton Keynes/ Oxford
Milton Keynes/Oxford
Milton Keynes/Oxford
The specialty trainee works Mon-Thur in MKH, and does 2 new outpatient clinics per
week with a mixture of routine and urgent new slots. There are opportunities to
attend specialist PD, MS, epilepsy & neuromuscular clinics and the trainee will
attend monthly botoulinum toxin injection clinics for focal dystonias. There is a large
in patient ward referral service of which a significant proportion is seen by the
registrar. Trainees are expected to discuss all cases with seniors and many will be
seen together with the trainee as part of training. Trainees are expected to use the
clinical material seen in ward referrals for CBD & mini-CEX WPBA material. There is
a weekly radiology meeting on the stroke unit and a monthly MK neurology radiology
meeting. A weekly medical grand round is organised and the trainee is expected to
attend and may be asked to occasionally present cases.
University College London Hospitals NHS Foundation Trust
University College London Hospitals NHS Foundation Trust (UCLH), situated in the
heart of London, is one of the most complex NHS Trusts in the United Kingdom,
serving a large and diverse population. In July 2004, we were one of the first NHS
Trusts to be granted Foundation Trust status. We provide academically led acute
and specialist services, both locally and to patients from throughout the United
Kingdom and abroad. We balance the provision of highly rated specialist services
with providing acute services to the local populations of Camden, Islington,
Westminster and the City of London. We have a turnover of £632 million and
contracts with more than 150 Primary Care Trusts to provide services. We treat over
500,000 outpatients appointments and admit 100,000 patients each year. We
employ 6,000 staff and are a major teaching centre offering training for nurses,
doctors and other health care professionals
The National Hospital Neurology and Neurosurgery (NHNN) is a leading centre for
the diagnosis, treatment and care of patients with a wide range of conditions such as
epilepsy, MS, Alzheimer's, stroke and head injuries. With its neighbour, the Institute
of Neurology, it is a major international centre for research and training.
Most (but not all) Oxford program trainees will rotate through the NHNN spending 8
months working with two of the subspecialty teams. The trainee works Mon-Fri in
London and is part of the neurology registrar on-call rota at the NHNN.
Teaching

There is an active post-graduate education programme with a weekly grand
round on Friday mornings incorporating two case presentations and regular
teaching sessions including neuropathology presentations, talks by visiting
lecturers, presentations of research, and clinical governance/audit sessions.
These mornings are attended by neurology trainees in all the JRH and DGH
posts.

A monthly neurology specialty trainee teaching half day is organised jointly
with the Wessex training programme; the venue alternates between Oxford
and Southampton.
Duties of Post




Day to day care of patients on the wards
The care of patients in outpatient clinics in Oxford and in District General
Hospitals in the region.
The provision of emergency consultations within the Oxford Hospitals
Teaching:
o The clinical students programme contains a four week neurology
attachment. StRs are involved in this teaching programme and also act
as Tutors.

o Postgraduate teaching to SHOs.
o Some lectures to Nurses, Social Workers and other paramedical
groups.
Maintenance of patient records, the completion of summaries and the writing
of letters as appropriate.
On Call Arrangements:
Trainees at the JRH and in the regional DGH posts take part in the neurology
registrar on-call rota at the JRH. This provides cover of neurology in-patients on the
neuroscience ward, and advice to hospitals in Oxford and the region. The rota is 1 in
10 and banded 1c. The neurology and neurosurgery SHOs are resident on call on
the neuroscience ward.
Trainees at the NHNN take part in the on call rota there.
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/your-workforce/need-to-know/european-working-timedirective
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/your-workforce/pay-and-reward/pay/pay-andconditions-circulars/medical-and-dental-pay-and-conditions-circulars 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/your-workforce/pay-and-reward/pay/pay-andconditions-circulars/medical-and-dental-pay-and-conditions-circulars
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/your-workforce/pay-and-reward/nhs-terms-andconditions/junior-doctors-dentists-gp-registrars/junior-doctors-terms-and-conditionsof-service-and-associated-documents
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/your-workforce/recruit/employment-checks/nhsemployment-check-standards
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.