HEALTH EDUCATION THAMES VALLEY:ACADEMIC CLINICAL FELLOWSHIPIN HISTOPATHOLOGY

Academic Clinical Fellowship (ACF) posts are awarded by the NIHR to University/NHS Trust/Deanery partnerships nationally through a formula mechanism and by competition. These posts form part of the NIHR Integrated Training Pathway, further details of which can be found on the NIHR TCC website

Please note: for 2016, in addition to the academic interviews, candidates will be required to attend and pass a clinical interview for the specialty they are applying to for academic training, if appropriate. Offers made will therefore be conditional upon meeting the required standard in the clinical interview. Please check the FAQs ( Applicant NIHR ACF FAQs.pdf) on the HETV website for more information.

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 (HETV) 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.

About Research in Oxford

Oxford University Hospitals NHS Trust and Oxford University, in partnership have an international reputation for research excellence. Patients benefit from world-class discovery and innovation and a growing portfolio of studies addressing major conditions including cancer, dementia and stroke. Oxford is a National Institute for Health Research Biomedical Research Centre, an Experimental Cancer Medicine Centre and a CRUK Major Cancer Centre. Oxford University Hospitals NHS Trust is the host NHS Trust for the Oxford Academic Health Science Network – one of 15 AHSNs across England and an Academic Health Science Centre. Opportunities for research are extensive and often involve novel collaborations with research groups outside of medicine e.g. with engineers.

Oxford has been recently designated as one of 11 Genomic Medicine Centres as part of the 100,000 Genomes Project main programme. This provides numerous opportunities for working with whole genome sequence data in both diagnostics and research. Oxford University Hospitals is home to the Oxford Molecular Diagnostics Centre (MDC), headed by Professor Anna Schuh and which is a fully CPA-accredited NHS laboratory that comprises the Oxford Regional Genetics Laboratory (ORGL), the Molecular Pathology and Haematology Laboratory, a clinical Next Generation Sequencing (NGS) core facility and the Oxford GEL BioRepository. Heads of Bioinformatics and Clinical Informatics are responsible for the analysis of NGS data and aggregation of phenotypic data, respectively. The MDC receives referrals from NHS, industry, clinical trials and research groups. It comprises a BRC funded R&D unit to develop, innovate, validate and evaluate clinical utility of genomics.

The NHS Cellular Pathology department at the John Radcliffe Hospital, Oxford has close links with several university departments, including the Nuffield Department of Clinical Laboratory Sciences, headed by Professor Alison Banham and the Nuffield Department of Surgical Sciences, headed by Professor Freddie Hamdy. Several of the consultants within the department have established proven track records in research with several grants and numerous publications in high impact international journals.

A key area for development within Cellular Pathology is digital pathology and image analysis, both on a diagnostics and research front. Digital pathology academic and working groups have been recently formed to drive this area forward and is likely to be a vibrant area of research activity over the next couple of years. Novel collaborations have been formed, including with bioengineers such as Professor Jens Rittscher at the Target Discovery Institute, University of Oxford.

Description of the Post

This is a post for up to 3 years duration. Approximately 2 of the 3 years will be spent in Oxford and the remainder in the regional DGH's. The post is for histopathology trainees who will be starting in year 2 or 3 of their training at the time of commencement of the post (ST2 or ST3).

This is a 75% clinical post with a 25% academic component. It is envisaged that this will be as a 3 month research block and 9 months clinical per year, however this is flexible and can be configured differently in the interests of the project and the appointee.

Several consultant pathologists within Cellular Pathology have academically funded time via their own research funding, the BRC or the CRUK Cancer Centre. Dr Clare Verrill leads the BRC funded team of pathologists. These pathologists are supporting large numbers of clinical trials, research projects and the 100,000 Genomes Project. Having academically minded pathologists, will enable the ACF to be mentored and supported in embarking on research projects.

It is envisaged that the ACF will embark on a molecular pathology project encompassing whole genome sequencing or a project employing elements of digital pathology and molecular pathologywithin their 9 months of research time. The ACF will have the opportunity to (at least in part) influence their area of study within molecular diagnostics. The project can focus on any tumour area, but areas of strong research interest currently include urological pathology, haematopathology or GI pathology (among others) or the project may involve more generic whole genome sequencing issues and cross tumour site boundaries involving multiple sites of interest. The research areas of molecular diagnostics and digital pathology have been chosen in order to equip the ACF with the necessary skills to function at consultant level integrating molecular diagnostics and digital pathology into their everyday work (skills which are essential for the future of histopathology).

The ACF will have an academic supervisor and an educational supervisor. The academic supervisor will act as a mentor. The ultimate aim of the post is to enable the appointee to develop a project in order to apply for external funding to undertake a DPhil/PhD. In the event that funding is not secured the appointee will return to full-time clinical training.

This post attracts an NTN(a).

The Histopathology Training Programme in HETV - General Information

The School of Histopathology in HETV is a popular school with training being well balanced between the District General Hospitals within the Thames Valley Region and the John Radcliffe Hospital in Oxford.

The region has a Histopathology Training School for the ST1s (Specialty Trainee year 1) which is based at Wycombe Hospital, although this School is integrated with the rest of the School of Histopathology in region. The specialty trainees in year 2 and above are based at Wycombe Hospital (High Wycombe), Wexham Park Hospital (Slough), the Royal Berkshire Hospital (Reading) and the John Radcliffe Hospital (Oxford). Generally those in years 2 and 3 of training who are not in an academic post are based in the District General Hospitals, before rotating to the John Radcliffe Hospital in year 4. The provision of cervical cytopathology training for those in Wexham Park Hospital and the Royal Berkshire Hospital is at the John Radcliffe Hospital and as such trainees on placement in either of these hospitals will be required to travel to the John Radcliffe Hospital for this component of their training. Similarly, training in diagnostic neuropathology and paediatric pathology in ST1 or ST2 will take place at the John Radcliffe Hospital. There is provision of training in soft tissue and bone pathology at the Nuffield Orthopaedic Centre which is part of OUH NHS Trust.

Rotations may at times change in response to clinical need from the Trusts and in accordance with training needs of the individual.

For the purpose of this ACF post, it is anticipated that approximately 2 of the 3 years will be spent in Oxford and the remainder of the time in the regional District General Hospitals. As such, the post-holder may find themselves employed by any of the following Trusts and placed in any of the following hospitals:

Trust / Hospitals and Locations
Buckinghamshire Healthcare NHS Trust / Wycombe Hospital, High Wycombe

Royal Berkshire NHS Foundation Trust / RoyalBerkshireHospital, Reading

Frimley Health NHS Foundation Trust / WexhamParkHospital, Slough

Oxford University Hospitals NHS Trust / John Radcliffe Hospital, Oxford

Buckinghamshire Healthcare NHS Trust

Buckinghamshire Healthcare NHS Trust is a major provider of community and hospital services in South Central England, providing care to over half a million patients from Buckinghamshire and neighbouring counties every year.

Wycombe Hospital

The Cellular Pathology Department is based at Wycombe Hospital. Wycombe Hospital is situated in the centre of the historic town of High Wycombe, and offers a wide range of surgical services, as well as 24 hour emergency medical care (including minor injuries) and specialist medical care, including stroke and heart conditions. The hospital also offers specialist cancer and urological services.

With some of the lowest waiting times for surgery nationally, the hospital is the area’s major hub for planned surgical care. Our top class teams carry out over 24,900 operations every year. Wycombe Hospital sees more than 36,000 inpatients and 145,000 outpatients a year and the emergency medical centre sees more than 44,000 patients.

Wycombe is also home to a newly-refurbished midwifery-led maternity unit aimed at providing a more home-from-home environment for women and their partners. This provides women with a wider choice on style of care, and complements our full consultant-led maternity service at Stoke Mandeville.

Cellular Pathology at Wycombe Hospital

Buckinghamshire Healthcare NHS Trust comprises 3 hospitals; Stoke Mandeville Hospital, Wycombe Hospital and Amersham Hospital. Cellular Pathology services in the Trust merged on the Wycombe Hospital site in April 2012. Wycombe Hospital is the site of most elective surgery in the Trust. The Breast Team within the Trust is merged on the Wycombe site. Intra-operative molecular diagnosis of lymph node metastases (OSNA) was introduced 5 years ago. The OSNA analyser is located in the Histology laboratory.

Buckinghamshire Healthcare hosts the Oxford Deanery (ST1) Cellular Pathology Training School.

Departmental Workloads:

Autopsies:

The post mortem workload averages approximately 800 per year between the two Mortuaries (mainly for H.M. Coroner).

Cytopathology:

Cellular Pathology receives more than 4,000 non-gynaecological cytology specimens including FNAs from a variety of sites. The department also receives about 65,000 gynaecological cytology specimens per year and provides the Cervical Screening services for Aylesbury, High Wycombe and Milton Keynes.

Surgical Pathology:

Cellular Pathology receives approximately 28,000 histopathology specimens per year.

Breast pathology (including breast screening) is well represented, as are gynaecological, urological and gastro-intestinal pathology and dermatopathology. The Regional plastic surgery unit is based at Stoke Mandeville Hospital and this department provides a wealth of skin and soft tissue pathology. We also receive skin biopsies from dermatology and general practice, GI, bronchial biopsies and prostatic core biopsies. There is an active Haematology and Oncology unit and biopsies of lymphoma and other tumour pathology are received. A small amount of ophthalmic pathology is generated by the active Ophthalmology Department and one of the Consultants has a special interest in this field.

Frimley Health NHS Foundation Trust

Frimley Health NHS Foundation Trust provides NHS hospital services for 900,000 people across Berkshire, Hampshire, Surrey and South Buckinghamshire.

Frimley Health came into being on the 1st October 2014, following the successful amalgamation of two neighbouring NHS trusts. Services are provided by three main hospital sites, Frimley Park, near Camberley, Heatherwood, at Ascot and Wexham Park in Slough along with a number of satellite centres.

Heatherwood and Wexham Park Hospital

Heatherwood & Wexham Park Hospitals NHS Foundation Trust (the Trust) is a district general hospital that serves a population of more than 450,000 people from the areas of Ascot, Bracknell, Maidenhead, Slough, Windsor and south Buckinghamshire. The Trust has achieved and maintained a Top 40 rating with CHKS for the last seven years.

The Trust employs approximately 3640 permanent staff who deliver a wide range of quality healthcare services from two main sites, Heatherwood Hospital in Ascot opened in the 1923, and Wexham Park Hospital in Slough opened in 1968. The Trust also provides outpatient clinics, a breast screening and diagnostic service, a chest clinic and other diagnostic tests at King Edward VII Hospital in Windsor, outpatient services and diagnostic tests at St Mark’s Hospital in Maidenhead, and outpatient services at Chalfonts and Gerrards Cross Hospital, and Fitzwilliam House in Bracknell.

Heatherwood & Wexham Park Hospitals became a foundation trust in June 2007. As a foundation trust it is accountable to its local community and aims to have representative membership of its catchment area, with members providing feedback to the Trust on the services that it provides.

Wexham Park Hospital in Slough has approximately 445 beds - General and Acute (excluding Day Surgery beds) with a full range of services including general medicine and its sub-specialties, paediatrics, general surgery, GIT and skin, urology, orthopaedics, obstetrics and gynaecology, otolaryngology, oral and maxillo-facial surgery and a sub-regional plastic surgery unit which has an extensive catchment area.

In the theatre complex there are 9 new theatres and two obstetric theatres. There is a large Accident & Emergency department, a 12 bedded combined Critical ITU/HDU, a 15 bed Day Surgery Unit and 16 bed Short Stay Unit. There is also an 8 bedded Coronary Care Unit, with 6 PCCU (Post Coronary Care Unit) beds and an angiography suite. There is also an excellent rehabilitation department, a centralised laboratory, and diagnostic imaging including a new spiral CT scanner and the MRI scanner suite on the site.

Heatherwood Hospital in Ascot has approximately 62 beds and 11 surgical trolleys, mainly for elective surgery for orthopaedics, general surgery, urology, otolaryngology, plastic surgery and gynaecology. There are 6 theatres including a Day Unit. There is also a minor injuries unit (seeing 15,000 patients in 2010/11 and 21,000 patients in 2011/12) and a diagnostic imaging unit including MRI and a CT scanner. Physiotherapy and rehabilitation are also on site.

Histopathology and Cytopathology at Wexham Park Hospital

The department provides a diagnostic service for Heatherwood and Wexham Park Hospital Trust and 2 PCTs. The annual workload consists of 2,943 non-gynaecological specimens including FNA, 20,790 NHS surgical specimens and 439 hospital and Coroner's post-mortems (the majority being Coroner’s cases).

The department provides a diagnostic service for a wide range of specialities including gastro-intestinal and colorectal, respiratory, gynaecology including colposcopy together with liver, urology, breast and other surgical material. There is no cardiothoracic or neurosurgical material.

The Cytology laboratory provides a wide range of diagnostic services including respiratory, urology, fluid and FNA cytology.

Oxford University Hospitals NHS Trust

The Oxford University Hospitals NHS Trust (OUH) is one of the largest NHS teaching trusts in the UK with a national and international reputation for the excellence of its services and its role in teaching and research. Clinical care is delivered by experienced specialists . Our 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 Banbury.

The Oxford University Hospitals NHS Trust was formally established on 1 November 2011 when the Nuffield Orthopaedic Centre NHS Trust merged with the Oxford Radcliffe Hospitals NHS Trust and became the seventh clinical division of the new expanded organisation.

On the same date a formal Joint Working Agreement between the Trust and the University of Oxford came into effect. This agreement builds on existing working relationships between the two organisations (see Research section below).

The Trust provides a wide range of clinical services, including both local and specialist services (including cardiac, cancer, musculoskeletal and neurological rehabilitation, and specialist children’s and neonatal services) as well as medical education, training and research.

The Trust employed over 11,500 people at the end of the financial year (2013/2014) and had a turnover of £868 million. The Trust provides general hospital services for people in Oxfordshire and neighbouring counties, and specialist services on a regional and national basis.

At the Trust in 2013/14 there were:

  • 1 million patient contacts;
  • 108,000 planned admissions;
  • 90,000 emergency admissions;
  • 130,000 emergency department attendances;
  • 1.4 million meals for patients
  • 8,315 babies delivered.

The Trust’s hospitals in Oxford serve an Oxfordshire population of 655,000 and the Horton General Hospital in Banbury has a catchment population of around 150,000 people in north Oxfordshire and neighbouring communities in south Northamptonshire and south east Warwickshire.

Oxfordshire Clinical Commissioning Group provides 37.6% of the Trust’s income for the delivery of patient services and 14.7% comes from other commissioners outside Oxfordshire, notably Buckinghamshire CCGs (Aylesbury Vale and Chiltern), Northamptonshire CCGs (Nene and Corby).