OXFORD DEANERY
IN ASSOCIATION WITH
SPECIALIST REGISTRAR / SPECIALTY REGISTRAR IN STROKE MEDICINE
FIXED TERM – ONE YEAR
TWO POSTS ROTATING BETWEEN OXFORD AND READING
AT SIX MONTHS
OXFORD DEANERY IN ASSOCIATION WITH
POST OF:SPECIALIST REGISTRAR / SPECIALTY REGISTRAR IN STROKE MEDICINE
Two one-year training posts are now available in stroke medicine within the Oxford Deanery. Each post rotates between the JohnRadcliffeHospital, Oxford and the Royal Berkshire Foundation NHS Trust, Reading after six months.
These posts were established in 2008 following the establishment of stroke medicine as a sub-specialty. They are jointly funded by a Department of Health initiative and the Oxford PGMDE.
Candidates are welcome to visit the department at theJohnRadcliffeHospital, Oxfordand are invited to contact Dr James Kennedy (University Lecturer and Honorary Consultant Physician), Oxford Radcliffe Hospitals NHS Trust, The John Radcliffe Hospital, Oxford, OX3 9DU. Enquiries about visits should be initially directed to Mrs Pramodi Majithia (Executive Assistant to Professor Buchan) on Oxford (01865) 220346.
Anyone wishing to visit the stroke service at the Royal Berkshire Foundation NHS Trust, Reading, could do so by contacting Dr André van Wyk’s secretary in the Elderly Care department on 0118 3225290.
Any person who is unable for personal reasons to work full-time will be eligible to be considered for the post. If such a person is appointed, modification of the job content will be discussed on a personal basis. Suitably qualified job-share candidates will receive serious consideration.
The following papers are attached:
- Job Description
- Person Specification - Selection Criteria
- Profile of the Oxford Radcliffe Hospitals NHS Trust
- Profile of the Royal Berkshire NHS Foundation trust
ABOUT THE PROGRAMME
Stroke medicine has recently been recognized as a sub-specialty of geriatric medicine, general (internal) medicine, acute medicine, rehabilitation medicine, clinical pharmacology and therapeutics, cardiology and neurology. A curriculum has been approved by the postgraduate medical education and training board (PMETB). The Department of Health (England) launched a national stroke strategy in December 2007 in order to improve and reinvigorate stroke care in England. The Department of Health has also agreed to fund the establishment of a number of training posts in Stroke Medicine during 2008. One of these posts has been awarded to the Oxford Deanery. This funding has been matched by the Postgraduate Dean, enabling the establishment of a second post.
This one year programme aims to provide a comprehensive training programme in all aspects of stroke medicine, including stroke prevention, acute stroke care and rehabilitation. Teams at the Royal Berkshire Foundation NHS Trust and the Oxford Radcliffe Hospitals NHS Trust have joined together to provide such a programme. The appointees will each spend six months in Oxford followed by six months in Reading.
The JohnRadcliffeHospital in Oxfordis home to a rapidly expanding Consultant-led hyper-acute stroke programme. Over twenty patients receive thrombolysis in Oxford each year. This clinical activity is coupled to increasing research activity with the development of an acute vascular imaging centre in close proximity to the Emergency Department (opening Spring 2009). There is ample opportunity to gain experience of neuro-radiology, including a dedicated stroke radiology conference each week.
In addition, Oxford has a strong record in the arena of stroke prevention. The appointee will regularly attend rapid access TIA clinics in Oxford and/or Banbury.
During the six months based in Reading, the trainee will experience a comprehensive and seamless stroke rehabilitation pathway at the Royal Berkshire NHS Foundation Trust. The acute stroke unit offers distinct ‘acute’ and ‘early rehab’ phases, with specialised neuro-rehabilitation provided for selected patients by Professor Collin and her multidisciplinary team. There is ongoing input from geratology, neurology and rehabilitation specialists.
Educational opportunities are numerous and include a weekly stroke medicine seminar organised by the University of Oxford Acute Stroke Programme.
Time may be made available during the year for the appointee to gain experience in fields such as vascular surgery and neurological intensive care, according to their training needs. The appointee will be assisted in arranging these placements by their educational supervisor.
JOB DESCRIPTIONfor theOXFORD PART of this ROTATION
With the exception of section 10, this job description describes the Oxford component of the rotation, primarily based at the JohnRadcliffeHospital. The appointee may also be expected to undertake duties at the HortonGeneralHospital in Banbury
1. JOB TITLE:
Specialist Registrar / Specialty Registrar in Stroke Medicine.
2.GRADE:
Specialist Registrar / Specialty Registrar
3.SPECIALTY:
Stroke Medicine
4.REASON FOR VACANCY
New posts (1 year, fixed-term)
5. SUPERVISING CONSULTANTS:
Professor Alastair Buchan
Dr James Kennedy
Dr Ian Reckless
6. EDUCATIONAL SUPERVISOR
Dr James Kennedy
7. PROGRAMME DIRECTOR & REGIONAL SPECIALTY ADVISOR:
Professor Alastair Buchan
8.ANNUAL AND STUDY LEAVE
All leave must be planned in advance and agreed with the supervising consultants. Another specialist registrar (Geratology) provides cover on the stroke unit and at least one specialist registrar must be available every weekday. Annual leave entitlement will be 5 or 6 weeks dependent on the appointee’s seniority.
9.SALARY
Salary will be calculated according to the Specialist Registrar / Specialty Registrar Scale. The post-holder’s point on the scale will be defined according to seniority in the parent specialty. A banding supplement may be available to appointees with sufficient contemporary GIM / Geratology experience to contribute to the geratology out of hours on-call and hospital at night rotas. This banding supplement is currently band 2B – subject to ongoing review. This post will be subject to intermittent hours monitoring. Applicants who do not feel that they will be able to contribute to the out of hours service as described should discuss matters with Dr Kennedy at an early stage. Ability to contribute to out of hours work is not taken into consideration at shortlisting / interview.
10. DUTIES OF THE POST
a)Principal Responsibilities:
In conjunction with the other registrar attached to the stroke unit (from geratology), the post-holder will be responsible for the day to day care of all patients referred to and managed by the stroke team. This will include initial assessment of referrals, ward rounds and outpatient clinics. The post-holder will form part of the acute stroke response team, assessing patients in the Emergency Department (and elsewhere within the hospital) for thrombolytic treatment immediately following stroke onset. An F2 - ST2 doctor is also attached to the stroke unit on a rolling 5 week rota.
b)Description of Working Pattern
The standard working day is 0830 until 1800. The post-holder will participate in the on-call geratologyrota (1 in 7), with prospective cover for annual and study leave. Whilst on-call, the post-holder will form part of the out-of-hours acute stroke response. In addition, the post-holder will provide support to the on-call house staff (F1 - ST2) covering patients on the acute stroke unit, Adams ward and Bedford ward (geratology). There are no direct admissions to geratology out-of -hours. The post-holder will be expected to be within 30 minutes of the Emergency Department at the John Radcliffe Hospital at all times when on-call. It may be possible to assist the candidate in identifying accommodation on site, where necessary.
c)Teaching
The post-holder will be expected to teach junior colleagues and medical students on a day-to-day basis. The post-holder will play an active part in regional stroke seminars, journal club, grand round presentations and training sessions for allied health professionals.
d)Administration/Management
The post-holder will be expected to ensure that accurate clinical records are kept and that timely discharge summaries are produced for patients under the care of the stroke team. In addition, the post-holder may be expected to assist in the organization of the acute stroke response rota.
e)Audit and data collection
The post-holder will be expected to contribute to ongoing data collection and audit within the stroke service. Novel systems of data collection are currently being developed by the acute stroke programme in Oxford.
f)Research
The post-holder will be expected to take an interest in ongoing clinical trials and research projects. The post-holder will be encouraged to participate in the design and conduct of new research projects wherever possible.
g)Study and Training
The post-holder will be encouraged to attend relevant stroke conferences in the United Kingdom and Europe. Where possible, the appointee will attend the Oxford regional training days in their parent specialty. Excellent Library facilities are available at the JohnRadcliffeHospital. The study leave budget is currently £700 per annum.
12. STRUCTURE OF THE STROKE SERVICE AND KEY PERSONNEL
The stroke service is not a distinct administrative department. Rather, it has close links with general medicine, emergency medicine, geratology, neurology and neuro-radiology. Managerial responsibility for most of the stroke services provided within the Oxford Radcliffe Hospitals NHS Trust is illustrated below:
Division A
↑
Directorate of Acute and Emergency Medicine with Geratology
↑
Department of Geratology
↑
Acute Stroke Service
In addition, further stroke services are provided through the NHS Department of Neurology. Clinicians from the University Departments of Clinical Geratology and Clinical Neurology make a significant contribution to patient care.
Medical Staff - Consultants
NHS
Dr Simon Winner (Geratology)
Dr Sudhir Singh (Geratology, GIM)
Dr Ian Reckless (Acute Stroke, GIM)
Dr Sebastian Fairweather (Geratology, GIM)
Dr Mike Ward (Geratology, GIM – HortonHospital)
Dr Wilhelm Kueker (Neuro-radiology)
Dr Dennis Briley (Neurology)
University
Professor Alastair Buchan (Acute Stroke, Neurology)
Dr James Kennedy (Acute Stroke, GIM)
Medical Staff - Other
NHS
1 Specialist Registrar (Geratology, GIM – by rotation, six months)
1 F2 / ST1 / ST2 (Core Medical Training – by rotation, 5weeks)
University
Dr Simon Nagel (Clinical Research Fellow, Nuffield Department of Medicine)
Senior Nursing Staff
NHS
Martin Westwood (Clinical Nurse Specialist)
Sarah Wheeler (Ward Manager, Stroke Unit)
University
Dr Janice Hinkle (Senior Research Fellow)
13. TIMETABLE
The timetable below represents a typical working week. It is for illustrative purposes and actual activities may vary following discussion with the appointee.
A.M. / P.M.Monday / Rapid Access TIA Clinic *
(location TBC) / Ward Round and MDT – HortonHospital
Tuesday / Acute Stroke Unit
Ward referrals / Stroke case presentation / seminar
Neuro-radiology review meeting
Acute Stroke Unit
Wednesday / Elective – specialty clinic * / Acute Stroke Unit
Ward referrals
Thursday / NDM case presentation / seminar
Rapid Access TIA clinic / Medical Grand Round
Clinical Audit & Private Study *
Friday / Acute Stroke Unit
Ward referrals / Acute Stroke Unit
Student teaching *
* The timing of these 5 sessions may change by to ensure maximal clinical exposure and educational benefit.
Together with the geratology registrar, the post-holder will be on-call for acute stroke response during the day from Monday to Friday. The appointee may participate in the Geratology on-call rota (including acute stroke response) on a 1 in 7 basis (with prospective cover). As part of the geratology on-call commitment, the post-holder may be expected to participate in the medical registrar ‘Hospital at Night’ rota on an occasional basis. Applicants from parent specialties that do not encompass general internal medicine should discuss their circumstances with Dr Kennedy. See section 9 above.
PROFILE
1.OXFORD RADCLIFFE HOSPITALS NHS TRUST
Overview
The Oxford Radcliffe Hospitals (ORH) is one of the largest teaching trusts in the country, with a national and international reputation for the excellence of its services and its role in teaching and research.
The Trust, which is based on two sites in Oxford and one in Banbury, provides general hospital services for the local population in Oxfordshire and neighbouring counties, and more specialist services on a regional and national basis. It employs about 9,500 staff.
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. The Trust, jointly with the University of Oxford, was recently awarded biomedical research centre status, by the Department of Health, making it one of the five pre-eminent centres in the country for translational medical research.
The Trust hosts the Oxford Deanery, the University of Oxford’s Department of Postgraduate Medical and Dental Education, which is jointly funded by the University and the NHS. The Trust works with the Deanery to provide one of the country’s pre-eminent centres for the training of doctors. It also works in close co-operation with OxfordBrookesUniversity, and hosts nurse and other healthcare professional training.
Performance and activity
The Trust has an annual turnover of £0.5 billion. It provides a district general hospital service for around 700,000 people in Oxfordshire and the neighbouring counties. The Trust’s specialist services serve a population of around 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.
Demand for Trust services has risen steeply in recent years and in 2005/6:
- 511,000 people attended outpatient appointments
- 117,000 people attended the emergency departments
- 48,300 people were admitted as inpatients for emergency treatment
- 20,200 people were admitted as inpatients for planned surgery
- 7,850 babies were delivered
In 2008, the final year of the Healthcare Commission’s ‘annual health check’, the Trust achieved an overall rating of ‘Excellent’ for Quality of Services.
New developments
In January 07 the Trust opened an extensive new wing for adult services at the JohnRadcliffeHospital, and the Children’s Hospital, Oxford. The new wing for adults, known as the West Wing, houses head and neck and other services which were previously based in the Radcliffe Infirmary in the centre of Oxford. The new Wing offers state of the art facilities for patients and for staff. It includes additional capacity or improved facilities for a number of services, including specialist surgery, neurosciences and the OxfordEyeHospital. In addition to clinical space, it provides a base for University teaching and research. The Radcliffe Infirmary building, which has housed medical services, teaching and research, since the 18th century, has been passed to the University of Oxford.
The Children’s Hospital, Oxford, brings together paediatric services which were previously spread across three sites in Oxford. It is a purpose-built building which provides general paediatric services for local children, and a range of specialist services, for children on a regional and national basis. The new Hospital was funded through the Private Finance Scheme which also funded the West Wing, supported by a £15 million fundraising campaign which allowed for the development of additional facilities for children and families, such as play areas, class rooms, and relative rooms.
Work is nearly complete on a new Cancer Centre on the ChurchillHospital site, in conjunction with PFI partners, OCHRE Solutions. This development will include additional medical and surgical beds, a new radiology department, head and neck cancer surgery centre, linear accelerators for radiotherapy and additional accommodation for chemotherapy patients. In addition to cancer services, the development will also provide facilities to support other services on the Churchill site. These include physiotherapy, a high dependency unit, ten operating theatres and a private patients’ unit. The centre will open in 2009.
The Trust is also expanding its cardiac centre on the John Radcliffe site, in order to provide facilities for a predicted rise in cardiology patients over the coming years. The new facilities include four additional catheter labs, for diagnosing heart problems, and for monitoring patients undergoing cardiology treatment, a recovery unit, additional beds and new facilities for staff. It is hoped that the new facilities will open in 2009. The development also includes the Oxford Acute Vascular Imaging Centre (University) which is expected to open at the same time.
Hospital Profiles
The JohnRadcliffeHospital
Headley Way, Headington, Oxford, OX3 9DU
Tel 01865 741166
The JohnRadcliffeHospital, in Headington is the main emergency site. It also provides acute medical and surgical services, trauma, intensive care, cardiac, women’s services and children’s services (now based in the Children’s Hospital on the site). Following the relocation of services from the Radcliffe Infirmary in January this year, the range of services has been extended to include neurosciences (neurology and neurosurgery), specialist surgery (ophthalmology; ear, nose and throat; plastic surgery), critical care facilities for specialist surgery and neurosurgery and a new day surgery unit.
The Hospital currently has 700 inpatient beds.
The ChurchillHospital
Old Road, Headington, Oxford, OX3 7LJ
Tel 01865 741841
The ChurchillHospital, which opened in 1942, is also in Headington and provides mainly non-emergency specialist services, including renal medicine and transplant, clinical and medical oncology, dermatology, chest medicine, infectious diseases and the recently extended palliative care centre. The Hospital has 317 beds. Work is well underway on the new Cancer Centre and associated surgical and diagnostic facilities, which will be completed in 2008.
The HortonGeneralHospital
Oxford Road, Banbury, Oxfordshire, OX16 9AL
Tel 01295 275500
The HortonGeneralHospital, which opened in 1872, is located in Banbury and provides general hospital services, including accident and emergency services, maternity and paediatric services, to the growing local population in the north of Oxfordshire and surrounding areas. The Hospital has 277 beds.