HEALTH EDUCATION THAMES VALLEY- SPECIALTY TRAINING PROGRAMME IN ACUTE CARE COMMON STEM (ACCS)
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.
TheACCS Training Programme
The ACCS training programme is a 3 year programme, starting at CT1and aimed at doctors who can demonstrate the essential competences to enter this level of training. Details of essential competences and qualifications are detailed in the MMC person specification for ACCSat CT1which is available from
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 programme is designed to support Core Training in Acute Medicine, Anaesthetics orEmergency Medicine.
It is anticipated that completion of this three year programme will allow doctors to complete the competences required for Core Training in Acute Care Common Stem and lead to eligibility to apply to the relevant Higher Specialty Training programme.
The Postgraduate Dean has confirmed that this post has the necessary educational and staffing approvals.
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 LocationsOxford University Hospitals NHS Trust / John Radcliffe, Oxford
The Horton Hospital, Banbury
Royal Berkshire NHS Foundation Trust / RoyalBerkshireHospital, Reading
Heatherwood and Wexham Park Hospitals NHS Foundation Trust / WexhamParkHospital, Slough
Milton KeynesHospital NHS Foundation Trust / Milton KeynesGeneral Hospital
Buckinghamshire Healthcare NHS Trust / Stoke Mandeville, Aylesbury
Wycombe Hospital, High Wycombe
Rotation Information
Rotations may at times change in response to clinical need from the Trusts.
Expected rotation arrangements for this programme are:
- Acute Care Common Stem training aims to provide trainees with a broad base of training in Acute Medicine, Anaesthesia, Emergency Medicine and Intensive Care Medicine.
- Over the first two years trainees will be attached to each of the four specialties; spending one year in Acute Medicine and Emergency Medicine and the other year in Anaesthesia and Intensive Care Medicine.
- The third year will be in the specialty you have nominated on your application form at the beginning of the programme.
- Applicants should be aware that those who complete one or two year programmes may not be provided with the complete relevant experience or competencies to apply for Anaesthesia at ST3 level or Emergency Medicine at ST4 level.
- Trainees will be expected to rotate within the Deanery. Rotations depend on
vacancies available and the training needs of the individual.
Anaesthetics/ITU Rotations usually begin the programme in an Anaesthetics/ITU post in either Reading; Wexham Park; Milton Keynes for a period of 12 months.
Emergency Medicine Rotations usually begin the programme in an Emergency Medicine post for 6 months in either Reading; Wexham Park; Buckinghamshire (Wycombe/Stoke Mandeville) Trust.
Acute Medicine Rotations usually begin the programme in an Acute Medicine post for 6 months in either Reading; Horton (Banbury); Milton Keynes
Rotations may at times change in response to clinical need from the Trusts. Expected rotation arrangements for this programme are:
Trust Information
Buckinghamshire Healthcare NHS Trust provides a wide range of high quality acute and community services from three acute hospital sites in Amersham, Stoke Mandeville and Wycombe, five community hospitals at Thame, Marlow, Buckingham, Chalfonts and Gerrards Cross and Waterside, and a number of community sites across the county. Specialist services include our regional dermatology, allergy and skin cancer centre, burns care and plastics sub-regional centre, cardiac services and the National Spinal Injuries Centre.
More than 6,000 staff serve residents across Buckinghamshire, Thame (Oxfordshire), Tring (Hertfordshire) and Leighton Buzzard (Bedfordshire) - a combined population of 500,000. It serves a much larger population, 1.5m for burns and plastic services and 14m for spinal injuries.
Stoke Mandeville
Stoke Mandeville Hospital is an acute hospital located on the edge of the market town of Aylesbury. It provides a range of hospital services including 24 hour accident and emergency, maternity, cancer care and a range of outpatient services. The hospital is the base foreye carefor the area.The regional burns and plastics unit provides specialist services to patients from Buckinghamshire, and as far away as Reading and Northampton. Stoke Mandeville Hospital is also home to the world renowned national spinal injuries centre.
Wycombe
Wycombe Hospital is situated in the centre of the historic town of High Wycombe, and offers a full range of planned surgical services, as well as 24 hour emergency medical care (including minor injuries) and specialist medical care, including stroke and heart conditions. There is also a midwifery-led maternity unit. The hospital also offers specialist cancer and urological services.
(All Information taken from Buckinghamshire Healthcare NHS Trust website
Oxford University Hospitals NHS Trustis one of the largest NHS teaching trusts in the UK and provides a wide range of clinical services and medical education, training and research.
The Trust provides high quality general hospital services for the local population in Oxfordshire and neighbouring counties, and more specialist services for patients from a wide geographic area. The Trust is also involved in a wide variety of research programmes, in collaboration with the University of Oxford and many other research bodies. The trust is made up of four hospitals - the John Radcliffe Hospital (which also includes the Children's Hospital and West Wing), Churchill Hospital and the Nuffield Orthopaedic Centre, all located in Oxford and the Horton General Hospital in the north of Oxfordshire.
- The John Radcliffe Hospital
The John Radcliffe Hospital (JR) was opened in the 1970s and is Oxfordshire's main accident and emergency site. Itis situated in Headington, about three miles east ofOxford city centre. It is the largest of the Trust's hospitals,covering around 66 acres. It houses the Children's Hospital and West Wing| and the John Radcliffe Women's Centre|. It also provides acute medical and surgical services, trauma|, intensive care and cardiothoracic services. It also houses many departments of Oxford University Medical School, is home to the George Pickering Education Centre| and base for most medical students who are trained throughout the Trust. The new emergency department at the John Radcliffe, opened in 2004, was judged the best designed hospital building in the country, in the Department of Health’s national Annual Building Better Healthcare Awards 2004. In October 2009 the new Oxford Heart Centre| opened at the John Radcliffe Hospital to meet the growing needs of heart patients in Oxfordshire and across the region.
- The Horton General Hospital
The Horton General Hospital in Banbury serves the growing population in the north of Oxfordshire and surrounding areas. It has over 220 inpatient beds and over 20 day-case beds, and is an acute general hospital providing a wide range of services.
The majority of these services have inpatient beds and outpatient clinics, with the outpatient department running clinics with visiting consultants from Oxford in dermatology, neurology, physical medicine, rheumatology, ophthalmology, radiotherapy, oral surgery and paediatric cardiology.
Acute general medicine also includes a short-stay admissions ward, a medical assessment unit, a day hospital as part of specialised elderly care rehabilitation services and a cardiology service.
Other clinical services include physiotherapy, occupational therapy, dietetics, radiology and pathology. The radiology service includes a managed mobile MRI and a breast cancer screening unit. Currently, there are also four main operating theatres and a large day-case unit.
The hospital employs 1,200 people, making it one of Banbury's biggest employers.The local community takes great pride in the hospital and provides exceptional levels of volunteer support through the League of Friends, the Authorised Volunteer Service, Pets as Therapy Volunteers and Horton GeneralHospital Radio.
(All Information taken from Oxford University Hospitals NHS Trust website
Royal Berkshire NHS Foundation Trustis one of the largest general hospital trusts in the country, providing acute medical and surgical services to Reading, Wokingham and West Berkshire and specialist services to a wider population across Berkshire and its borders.
The trust has over 4,800 staff, 607 acute, 44 paediatrics and 57 maternity post natal beds and 204 day beds and spaces.
Royal Berkshire Hospital
The Royal Berkshire Hospital is based on a single site near the centre of Reading. The hospital is the main base for the Trust and provides a wide range of services. Full information on the Wards and Services available at the Royal Berkshire Hospital can be found by visiting the Trust website
Heatherwood and Wexham Park Hospitals NHS Foundation Trustbecame a Foundation Trust in 2007. The Trust employs over 3,700 permanent staff delivering quality healthcare 24 hours a day 365 days a year. Heatherwood and Wexham Park Hospitals NHS Foundation Trust provides hospital services to a large and diverse population of over 400,000 which includes Ascot, Bracknell, Maidenhead, Slough, south Buckinghamshire and Windsor. Heatherwood has been a hospital since the 1920s and Wexham Park Hospital since 1968.
The Trust also manages outpatient services at:
- King Edward VII Hospital in Windsor
- St. Mark's Hospital in Maidenhead
- Fitzwilliam House in Bracknell
- Chalfonts Outpatients in Chalfont St Peter
Wexham Park
Wexham Park Hospital has 521 beds with a full range of services including general medicine and its sub-specialties, paediatrics, general surgery, vascular surgery, urology, orthopaedics, obstetrics and gynaecology, otolaryngology, oral surgery and a sub-regional plastic surgery unit.
The hospital contains a range of facilities, including:
- A large Accident and Emergency department
- A new theatre complex with 9 general theatres and one obstetric theatre
- A 12 bed combined Critical Intensive Therapy/High Dependency Unit
- A 16 bed Day Surgery Unit and a 16 bed Short Stay Unit
- An 8 bed Coronary Care Unit accompanied by a 6 bed Post Coronary Care Unit, which acts as a step down unit
- An Angiography Suite
- An excellent new rehabilitation department
- A centralised laboratory
- Diagnostic imaging including a new spiral CT scanner and MRI Scanner Suite
- A new state of the art Central Sterile Services Department (CSSD)
(All Information taken from Heatherwood and Wexham Park Hospitals NHS Foundation Trust website
Milton Keynes Hospital NHS Foundation Trust is a medium size hospital serving the 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. It continues to develop its facilities to meet the needs of a growing population.
The hospital provides services for all medical, surgical and child health emergency admissions.
In addition to providing general acute services Milton Keynes Hospital increasingly provides more specialist services, including cancer, cardiology and oral surgery and has the responsibility for treating premature babies born locally and in the surrounding areas. Some of the babies we treat are born as early as 24 weeks old (16 weeks early) and weighing as little as 500 grams. The Trust employs around 3000 staff.
(All Information taken from Milton Keynes Hospital NHS Foundation Trust website
Teaching
The primary aims of the three year programme is to deliver the ACCS curriculum and to provide trainees with the opportunities to gain the necessary competences required to be for eligible to apply for higher training in their chosen speciality.
Health Education Thames Valley is committed to developing postgraduate training programmes as laid down by GMC, Colleges and Faculties and by COPMED - the Postgraduate Deans Network. At local level college/specialty tutors work with the Programme Director and Directors of Medical Education in supervising these programmes. Trainees will be expected to take part in these programmes (including audit) and to attend meetings with their nominated educational supervisor.
All posts within the training programme are recognised for postgraduate training by the General Medical Council (GMC) in accordance with their standards for training.
Study leave is granted in accordance with Deanery/Trust policy and are subject to the maintenance of the service.
Curriculum
The curriculum for Acute Care Common Stem can be found on the ACCSUK website:
Duties of Post
All posts have a service element and the following covers the majority of duties. There will be minor variations in different hospitals and during different attachments. The list below is not exhaustive but is aimed at covering the majority of duties:
1.To take part in the day to day management of patients under the care of their Consultant(s), supervise the F1/F2 where necessary and in turn be supervised by the more Senior ST and Consultant(s).
2.Perform, with supervision, procedures appropriate for their level and experience.
3.Be expected to be competent in all general areas of the specialty consistent with training and experience and to cover the work of colleagues as appropriate.
4.Pre-operative assessment, management of pre-medication of patients scheduled to undergo routine and emergency surgery.
5.Administration of Anaesthetics (local and general).
6.Post operative assessment and management of postoperative problems in conjunction with surgical colleagues.
7.Liaise with nurses, doctors, allied health professionals, patients, relatives and senior medical staff
8.Attend and participate in ward rounds as timetabled
9.Attend outpatient clinics as timetabled
10.Take part in rostered emergency work.
11.Complete discharge summaries.
12.Study for higher examination and maintain continued professional development.
13. Attend weekly educational and multidisciplinary sessions
14. Undertake audit at various times throughout the rotations
15.Teach medical students, nurses and allied health professionals as directed.
16.Co-operate with members of the personnel department when monitoring hours of work and other personnel issues.
17.Attend induction in each hospital or new department
18.Maintain appropriate training documentation.
19.Comply with all local policies including dress code, annual and study leave
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 52-hours 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.
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
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
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
Annual Leave – your entitlement to annual leave will be five or six weeks per annum depending on your previous service/incremental point, as set out in paragraphs 205-206 of the TCS. The TCS may be viewed at