Ophthalmology - Oxford Deanery

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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
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