OXFORD DEANERY SPECIALTY TRAINING PROGRAMME IN OPHTHALMOLOGY (ST1 and above) 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 Ophthalmology Training Programme The Ophthalmology training programme is a seven year programme, starting at ST1. 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 Ophthalmology. 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: Trust Oxford University Hospitals NHS Trust Hospitals and Locations West Wing, John Radcliffe, Oxford, http://www.ouh.nhs.uk/ Buckinghamshire Healthcare NHS Trust Stoke Mandeville Hospital http://www.buckshealthcare.nhs.uk/ Milton Keynes Hospital NHS Foundation Trust Milton Keynes General Hospital http://www.mkgeneral.nhs.uk/ Royal Berkshire NHS Foundation Trust Royal Berkshire Hospital, Reading http://www.royalberkshire.nhs.uk/ Prince Charles Eye Unit Windsor. http://www.royalberkshire.nhs.uk/default.aspx Rotation Information The rotation is divided into 6 month blocks although most placements are for a minimum of one year. All trainees are expected to rotate to the different hospitals in the scheme. The training requirements are monitored yearly at the ARCP and this will also help plan future placements. All trainees rotate through the Oxford Eye Hospital. As a small school with 24 Specialist trainees on the rotation it is able to provide excellent training in all aspects of Ophthalmology with trainers taking a personal interest in the development of their trainees. The trainees also form a close knit group and are happy to help one another progress. There is a wealth of clinical experience to be gained with plenty of hands on experience and an appropriate level of supervision. All of the sub-specialty areas of ophthalmology are covered allowing advanced trainees to specialise further. Many of the consultant trainers are involved at a national level in training or research and development in their sub-specialty area making the training rotation a particularly enthusiastic one. The academic department of Ophthalmology in Oxford has an excellent reputation and plays an important part in the clinical school. A Clinical Lecturer post has been established to support liaison between the clinical and academic departments. Opportunities exist for some trainees to take time out to undertake research leading to a MD or PhD. Involvement in research is also encouraged during clinical training. The school has a website for trainees www.oxeyes.org Trust Information Royal Berkshire NHS Foundation Trust The Royal Berkshire NHS Foundation Trust serves a population of approximately 0.8 million. The Trust provides services to across West Berkshire covering the areas of Reading, Wokingham, Newbury and part of South Oxfordshire. Reading is a University town and a centre for administration and light industry. Wokingham is predominantly a commuter locality and Newbury has a mix of light industry, administration and agriculture. The Royal Berkshire Hospital The Royal Berkshire Hospital was founded in 1839, the original buildings are still in use to this date and are found to the north of the hospital site. The Hospital became a Trust on 1 April 1992. The Chairman is Mr Colin Maclean, the Chief Executive is Professor Ann Sheen and the Chief Medical Officer is Professor Rachel Hall. A large consolidation project to bring both the Royal Berkshire Hospital and Battle Hospital to one site was completed in 2005. New facilities include a new main entrance, extension to the South Block including facilities for Orthopaedics, Surgery and Anaesthetics, a new Accident and Emergency department and Battle Block in the centre of the Royal Berkshire site which holds services previously housed at our Battle site and new parking facilities. As part of Consolidation, a new Clinical Decision Unit (CDU) has opened at the Royal Berkshire site, as a centre of excellence for all medical patients requiring hospital assessment. This is located in the heart of the hospital close to all investigation facilities and the A & E department. There will also be a new Higher Monitoring Area of four beds (HDU) providing experience in non-invasive ventilation, CVP monitoring and step down from ITU. The Trust is one of the largest employers in Reading with approximately 4,800 staff, with 708 acute beds and 204 day beds across both sites. In 2008 the Eye department treated over 67,000 out patients and performed 12,000 procedures. Berkshire (Newbury) Community Hospital lies nineteen miles to the west of Reading this was opened in 2005 and incorporates a combined unit for Community Dental Services and Oral Surgery & Orthodontic Services. There are further Community Hospitals in Reading, Henley and Wokingham, with psychiatric services being provided at Prospect Park Hospital, Reading. Special Services Provided and Training Opportunities The Eye Department includes a Day-Bed Unit, in-patient beds, 3 operating theatres with video recording facilities, a Lucentis clean room, pre operative assessment suite, casualty department and outpatient facilities. The out-patient department runs general clinics, specialist clinics and eye casualty, and there are excellent orthoptic, low vision, contact lens and prosthetic services. The department has equipment for anterior and posterior segment photography, fluorescein and indocyanin green angiography, A&B-Scan ultrasound, corneal topography, ultrasound pachymetry, specular microscopy, optical coherence tomography, Heidelberg retinal tomography and IOLMaster biometry. The clinic rooms have networked facilities for image viewing. There are also Yag, PDT and Pascal lasers in the outpatient department. There are extensive surgical opportunities for trainees, including micro – incision phacoemulsification ( C-mics, B-mics),23 gauge Vitrectomy, indirect retinal laser, intravitreal therapy, corneal surgery (including penetrating keratoplasty, DALK, DSEK, intacs, stem cell transplantation, cross-linking), endo-nasal DCR with videoimaging and other lacrimal procedures, oculoplastic, strabismus, and glaucoma surgery. Consultants at the Royal Berkshire Hospital: Miss B M Billington - Vitreoretinal & paediatric (retires Jan 2011) Miss A S Bacon - Oculoplastics Mr P H Constable - Glaucoma Mr V Tanner - Vitreoretinal Mr M Leyland - Cornea & ocular surface (Lead Clinician) Mr A Pearson - Oculoplastics & lacrimal Miss S-L Watson - Medical Retina (College Tutor) Miss A. Smith – Medical Retina Mr A. El-Amir – Vitreo Retinal Constable and Leyland work at both the Royal Berkshire & Newbury Hospitals, Tanner, Pearson, Smith, Watson, El-Amir also work at Prince Charles Eye Unit, Windsor, Bacon works at Townlands and Billington at Wallingford. Other Medical Staff: There are 2 Associate Specialists, 3 Staff Grade Doctors and Fellows in Vitreo retina and Oculoplastics. The Prince Charles Eye Unit, King Edward V11 Hospital, Windsor The hospital is situated in the ancient Royal Borough of Windsor with delightful tourist attracting town and country facilities, including the river Thames and Windsor Great Park. The hospital is situated near Windsor Great Park some 2 miles off the M4 and Slough. There is easy access to the town centre, which has good shopping facilities. There are car parking facilities on site. The Prince Charles Eye Unit, Windsor and the Royal Berkshire NHS Foundation Trust, Reading, together form the Berkshire Eye Service. The Ophthalmology Unit The Unit consists of two operating theatre suites with day-case facilities, a Lucentis clean room, an out-patient department and Casualty. There are also outpatient clinics at St Mark’s Hospital. The Unit is well equipped with modern operating facilities: Stellaris (B and L), Infinity (Allergan) and Signature(AMO) phaco machines, outpatient lasers, glaucoma and retinal diagnostic equipment, and a photographic department run by full-time clinical photographer. Imaging facilities are networked to clinical stations and an electronic patient record and administrative system is used throughout (Medisoft) Speciality Services provided by the Unit include Surgical and Medical Retina, Paediatrics, Glaucoma Oculoplastics/Lacrimal, Contact lens, Orthoptic and Low Vision. The Ophthalmology Team Medical Director Dr Johnathan Fielden (Consultant Anaesthetist RBH), Surgical Divisional Director Miss Brenda Billington, Ophthalmologist, Lead Sister Sr Sue Nuth Sr Awelewa Sr Ward (Ward) (Theatre) Nursing Nursing Ophthalmology Clinical Director Mr Martin Leyland G Horne S.Hanlon Consultants Orthoptists (Clinics and Casualty) Mr R Packard Mr S Kheterpal Mr V Tanner Photography Nursing Mr J McAllister (Retires 2010) Technicians Mr A Pearson Miss SL Watson Mr A El-Amir Miss A.Smith 6 Associate Specialists and 3 Trust Grades Clerical Clerical Clerical 3 Ophthalmic Trainees Unit Administrator : Miss Claire Baldwin Milton Keynes Hospital NHS Foundation Trust Milton Keynes Hospital opened in 1984 and since that time the town has grown at rapid pace. Our local catchment population now stands at 270,000 and is forecasted to grow to 412,000 by 2031. Milton Keynes Hospital is an ambitious and high performing Trust with a vision to become the hospital of choice for the local population. The Trust achieved Foundation status in 2007 and has maintained its high performance standards, being awarded good/good for use of resources and clinical standards in the Care Quality Commission annual health check. The Trust’s Vision statement is that: Milton Keynes Hospital will be the health care provider of choice and committed to treating you well and growing with Milton Keynes. Milton Keynes Hospital will be recognised to – Be the health care provider of choice Provide excellent services in line with best practice to all patients Deliver patient care in a way that inspires public confidence Respond effectively to the new NHS environment and the growth in the local area Ensure services are grounded within safe systems and processes Value staff by providing an environment where they can develop and grow, being adaptable to change in order to provide a high quality service Develop a performance culture where services are continually reviewed and improved in line with patients To be cost effective and financially secure Outpatient Clinics The Ophthalmology Department is a self contained unit which houses the Eye Clinic as well as the Orthoptic and Optometry Departments. The unit also contains the secretarial offices. The Ophthalmic Unit This eye department serves Milton Keynes and the immediate surrounding areas. It consists of an out-patient department and day case surgery. In-patients are admitted at Stoke Mandeville Hospital (SMH) at Aylesbury, approximately 20 miles away. The Consultants at Milton Keynes Hospital are part of the Buckinghamshire group of Ophthalmologists consisting of 10 Consultant Ophthalmologists. At Milton Keynes Hospital there is a daycase ward and most eye surgeries are performed, including phakoemulsifcation cataract surgery. The out-patient eye department is in a self-contained spacious unit with 10 consulting rooms (beside the orthoptic (4 rooms) and optometry (2 rooms) clinical areas) and 2 treatment rooms which are fully equipped. Equipment includes ultrasound A & B scans, YAG and new Argon lasers [with an indirect delivery system], fundus camera, corneal topography and an OCT. There are three part-time Optometrists with contact lens and a Low Visual Aid Service. Three full-time and 3 part-time Orthoptists support the department as well as the Community Orthoptic Screening Service. The Artificial Eye Service is supported within the prosthesis laboratory of the dental department. The ophthalmic secretaries’ accommodation is next to the eye out-patient department. There is an active teaching programme for junior staff in Ophthalmology across Buckinghamshire, one half-day weekly based at SMH and Oxford Eye Hospital. There is a monthly journal club held at the Department in Milton Keynes. Continuous medical education at all levels is encouraged. There is a monthly regional Ophthalmology audit held at SMH. This self-contained unit is at present situated within the hospital campus with easy access and parking, and the railway station is nearby (MK to London ~40 minutes). Specialist Trainees are responsible to Consultant Ophthalmic Staff comprising: Mr B Kumar Mr A Assaf Mr R Bates THE DEPARTMENT OF OPHTHALMOLOGY Staffing 3 Consultants 2 Associate Specialist Ophthalmologists 2 Specialist Registrars 1 Clinical Fellow Additional Staff Members Clinical Fellow Locum Clinical fellow – not filled 2 OSTs (Oxford Deanery) ASTO in Paediatric Ophthalmology & Strabismus (in conjunction with Oxford) - not always filled ASTO in Oculoplastics (in conjunction with SMH) – not always filled Current Support Team There are 3 ophthalmic secretaries. Senior Nurses x 2 Orthoptics Head Post advertised There are 6 orthoptists: 3 full-time & 3 part-time with a total of 4.5 WTE Optometry Head Optometrist 3 part-time optometrists Technicians There are 2 technicians 1 retinal photography and OCT 1 visual field technician Management DAVID BOWEN-CASSIE Divisional Manager Buckinghamshire Healthcare NHS Trust Buckinghamshire Hospitals NHS Trust was established in April 2003 with the formal merger of South Buckinghamshire NHS Trust and Stoke Mandeville Hospital NHS Trust. A range of clinical networks has evolved to serve the new Trusts population. However, considerable work is being undertaken on the further development of clinical services across the three hospitals and with neighbouring trusts, and this will form the foundation of a possible reconfiguration in the new Trust, subject to public consultation Population we look after The Trust serves residents in Buckinghamshire, Thame (Oxfordshire), Tring (Hertfordshire) and Leighton Buzzard (Bedfordshire) - a combined population of 500,000. It serves a much larger population of 1.5m for Burns and Plastic Services and 14m for Spinal Injuries. Three Primary Care Trusts are responsible for commissioning healthcare for this population (except for Bedfordshire and Hertfordshire patients): Vale of Aylesbury PCT; Chiltern and South Bucks PCT; and Wycombe PCT. Resources and Services There are three hospitals in the Trust – Amersham Hospital, Stoke Mandeville Hospital, and Wycombe Hospital. The Trust currently has 4,700 staff and an annual budget of £185m. Between them the hospitals provide a comprehensive range of acute hospital services. Both Wycombe and Stoke Mandeville Hospitals have A&E services; critical care support, general surgery and general medicine. Wycombe is the base for Urology and Vascular Surgery and for the cardiac catheterisation service, Amersham the base for Dermatology and Stoke Mandeville is the base for Ophthalmology, Burns and Plastics and Spinal Injury services. The last two services are participating in regional/multi-regional reviews. Wycombe and Amersham Hospitals were significantly upgraded as a result of a recent £40m PFI scheme. Stoke Mandeville’s PFI scheme includes medical wards, elderly care wards, paediatrics, day care and space for the burns’ unit. The current value is £42m. Building should start early in 2004 and be completed by the end of 2005. The Trust hosts the Buckinghamshire Shares Services – an organisation providing finance, HR, IT and procurement services for the majority of NHS organisations in Buckinghamshire. There are day nursery services available on all three-hospital sites. Stoke Mandeville Hospital Ophthalmic Unit The Stoke Mandeville Ophthalmic Unit covers in-patient treatment for Aylesbury Vale, Wycombe, Milton Keynes and Hemel Hempstead districts. This is a catchment population of about 900,000. Two Specialist Trainees with the four Senior House Officers make up the junior staff. There is a rotation of junior staff amongst the eight Consultants for all in-patient work. The Specialist Trainees duties currently involve out-patient attendance at High Wycombe. Full facilities exist for ocular investigation, including fluorescein angiography, OCT, ultrasound and anterior segment photography. There are facilities for laser treatment including Nd YAG, Argon, Dye, PDT and Transpupillary Thermotherapy. There is also an excellent library and a well established teaching programme. Specialist Trainees are responsible to Consultant Ophthalmic Staff comprising: Mr R A Bates Mr L Benjamin Mr S N Cox Mr B James Miss R Khooshabeh Mr R Smith Mr B Kumar (Milton Keynes) Ms C Moorman Mr K Manuchehri Ms A Shaikh (Locum Post) Structure of Firm: 11 Consultants 10 Staff and Associate Specialist Ophthalmologists 2 Specialist Registrars 4 Senior House Officers Oxford University Hospitals NHS Trust The Oxford Eye Hospital is based on Level LG1 of the West Wing at the John Radcliffe Hospital. It is where the Eye Casualty and all the outpatient clinics (including laser, orthoptic, optometry, pre-assessment, photography, OCT and FFA/ICG clinics) are located. It also houses the secretaries’ and Consultant offices, as well as the registrars’ room. All ophthalmic inpatients are admitted to the Specialist Surgery In-Patient ward (SSIP) on Level 0, which is shared with ENT and Plastics. The West Wing theatres are also located on this level (Theatres 6 and 7 are Ophthalmic theatres), as is the Lichfield Day Surgery Unit, which is separated into a local and general anaesthetic side. STAFF, DEPARTMENTS & CONTACT NUMBERS Consultant Staff Victor Chong (Diabetic and retinal vascular disease) Susan Downes (Macular disease & genetics) John Elston (Neuro-Ophthalmology, Ocular motility & Paediatric Ophthalmology) Susan Hague (Oculoplastics) Martin Leyland (Cornea) Prof. Rob MacLaren (Vitreo-retinal & inherited retinal diseases/genetics) CK Patel (Adult & Paediatric Vitreo-retinal, ROP) Paul Rosen (Vitreo-retinal, Cornea and Refractive surgery) John Salmon (Glaucoma) SAS Grades Kikkeri Arun Moustafa Issa Stella Hornby Barbara Crofts Alan Brooks Fellows There are usually 2 medical retina fellows, 1 VR fellow and 1 Oculoplastics fellow. Departments & Extensions Main reception Eye Casualty Orthoptics Optometry Photography Lichfield: Reception LA GA SSIP Theatre 6 Theatre 7 34131, 31549, 34024, 31092, 34135 31494, 31104, 31103 (Doctor’s room) 34171, 34742 34740, 34994 31139, 31140 31296, 31297, 31298 31401 31309, 31310 34277, 31230, 31233 31334, 31327 31335, 31328 Useful Contacts NAME Secretaries: Jill Hudson Jennifer Clare Davies Mary Spearman & Karen Kath & Sarah Vicky Hart Sue Clarke Helen Emsden Jeannette Mitchell Alexina Fantato Nicola Justice Bed Manager Anaesthetic co-ordinator ROLE EXTENSION Miss. Hague Mr. Chong Mr. Patel, Miss. Downes Mr. Rosen, Mr. Elston Mr. Salmon, Mr. Leyland AMD Co-ordinator Outpatient Sister/Preassessment Waiting List co-ordinator Theatre Sister Research Sister Outpatients/clinic coordinator Inform of all admissions Inform of all emergency out-of-hours admissions to theatre 31578 34736 34735 34202 34360 31080 31117 31575 31356 31053 34134 Bleep 6521 Bleep 6522 OUTPATIENTS Clinics The majority of trainees will undertake clinics based at the OEH, however some trainees will also be timetabled to once weekly clinics at the Horton General Hospital in Banbury or Northampton General Hospital. All clinics start at 08.30 or 09.00am and 13.30 or 14.00 in the afternoon. However, for the smooth running of clinics, it is advisable to review all medical notes approx. 30 minutes beforehand so that any requests for dilation, visual fields, OCT, blood results, etc can be written up for the nursing staff prior to clinic. Appointments, Listing & Dictation There is a front sheet attached to every set of notes which records the outcome of the clinic visit (i.e. discharge, further follow-up and time-frame, or waiting list). This must be filled in and handed to every patient so appropriate follow-up can be arranged at main reception. All patients listed for surgery in theatres must have a yellow waiting list sheet (found in every clinic room) completed and given to the patient to take to reception. All referrals to other Consultants within the department must be discussed with the Consultant in charge of the patient. Every patient, especially all new referrals, patients who are listed for surgery or those whose treatment has changed in any way, must have letters dictated to the GP. At the end of clinic, bind all notes with your Dictaphone and dictation front sheet and give to the appropriate secretary. Photography & Imaging All requests for photography, autofluorescence, OCT, FFA and ICG must have a yellow slip filled in and the notes taken to photography. The vast majority of requests can usually be accommodated on the same day. Most images are accessible on clinic computers under the VISUPAC software, and some computers have additional access to the Heidelberg program. Lasers The department has a double-frequency YAG, Pascal and Micropulse laser. If you are not familiar with any of the machines, please ask a more senior member of staff/colleague to give you a brief induction. The keys for the lasers and lenses can be obtained from the nursing staff. If you are doing a laser list, there is a Laser Clinic letter proforma that needs to be filled in for every patient. All laser procedures must be recorded in the laser book. IN-PATIENTS All inpatients are admitted to SSIP via the bed manager. For emergency admissions (including to theatres), please inform the Consultant-on-call of the admission, and hand over to a member of their firm the next morning, so that the patient can be reviewed before 9am if possible. All in-patients, especially post-ops requiring discharge, must be reviewed and paperwork/TTOs completed prior to 9am. THEATRES Elective cases All elective pre-op patients are reviewed on Lichfield prior to surgery. Operation notes and biometry are completed using the Medisoft software for every patient for most cases, and on Casenotes for VR and emergency procedures. Please ensure any post-op patients requiring overnight admission have complete drug charts written up and have adequate analgesia prescribed, otherwise the first on-call will be requested to do so. Emergency cases All out-of-hours emergency admissions to theatre (especially if requiring a GA) need to have a white emergency sheet completed (found next to the emergency board in theatres) so that the patient can be added to the emergency board. The anaesthetic co-ordinator and on-call theatre nurses must also be notified. It is important to talk to the on-call anaesthetists if necessary and ensure there is a porter available. Any VR admissions, please discuss with the VR fellow. EYE CASUALTY Eye Casualty operates from 9am to 5pm Mon-Friday, with an emergency clinic running between 10am and 4pm on the weekends. The department operates a booking system whereby patients are assessed either by phone or in person and offered an appointment. Each of the 10 weekly sessions is usually covered by one doctor. If you would like a second opinion, or would like to discuss an admission, please contact the 2nd on-call registrar. Try to minimise follow-ups in Casualty, and any patient being followed up more than 3 times for the same clinical problem should ideally be referred to the appropriate clinic. Conditions that require only one or 2 further follow-ups (e.g. mild/improving microbial keratitis or anterior uveitis, etc) can usually be accommodated in the Primary Care Clinic. All patients require completion of an electronic GP letter on Medisoft. Teaching There is an excellent weekly ophthalmic postgraduate teaching half day in Oxford on Monday afternoon. For trainees at Milton Keynes and Stoke Mandeville teaching is undertaken at Stoke Mandeville on Monday afternoon save for the first Monday of the month when trainees go to Oxford. Teaching also occurs at a local level in all Hospitals. Duties of Post Trainees are expected to undertake clinical duties (clinics, operating theatres, laser lists and casualty sessions), attend teaching sessions, take part in audit and research and at more senior levels have administrative responsibilities. Timetables are agreed locally between the College tutor and the Clinical Director, the balance of sessions covering these activities will vary between trusts and will also depend on the level of experience of the trainee. All trainees take part in an on call rota throughout their training. Separate rotas run at Oxford, Stoke Mandeville and Reading/Windsor. Trainees must undertake WBAs as outlined by the College of Ophthalmologists (http://www.rcophth.ac.uk/) curriculum in a timely fashion. Each trainee is allocated an educational supervisor at the hospital where they work. 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/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. November 2011