Health Education Thames Valley:
Academic Clinical Fellowship in Neurology (ST3)
Research area in Older People and Complex Health Needs
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 website
All ACF posts are allocated an NTN (a). The area of research that the ACF is expected to work in is related to older people and complex health needs. This is a condition of the post set by NIHR.
In HEE Thames Valley, in partnership with the University of Oxford, we have established an Academic School, theOxford University Clinical Academic Graduate School (OUCAGS) ( All academic trainees become a member of the School and through it have access to a wide range of clinical academic training and funding opportunities as well as mentorship.
The objectives of the ACF programme are to combine specialist training with research training and to identify an area of academic and clinical interest in whicha doctoral fellowship application or postdoctoral funding application (if a doctorate is already held) is prepared
Please note: in addition to the academic interviews, candidates will be required to attend and pass a clinical interview for thespecialty in which they wish to train, unless they already hold an NTN in that specialty. 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 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.
Research in Oxfordand Older People and Complex Health Needs Research Opportunities
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. The ACF is likely to be based in theNuffield Department of Clinical Neuroscience (NDCN), which includes the Oxford Parkinson's Disease Centre (OPDC),is one of Europe’s largest clinical neuroscience departments (£286m research funding over the last five years) and ranked first place in overall quality in the research excellence framework (REF2014).
The area of research that the ACF is expected to work in is related to older people and complex health needs. This is a condition of the post set by NIHR. The examples below demonstrate the breadth of research available in this area and the ACF will be supported to identify an area of interest:
Long-term neurological conditions (LTNC) are highly prevalent amongst older people, creating complex health needs. The LTNCs theme of the Oxford Biomedical Research Centre (BRC 3) focusses on improvement of quality of life and reduction of healthcare costs using pragmatic, clinically relevant research projects for rapid translation of recent advances in biomedical research for the benefit of major healthcare challenges posed by LTNCs. Cognitive impairment and motivation, sleep and mood all impact on quality of life of patients and carers. Technology for remote monitoring using wearable sensors of EEG, physical activity and sleep state will provide quantitative measures for management of patients at home – to avert crises and acute admissions and to monitor effects of medication change. We aim to improve stratification for prognosis and earlier, aggressive intervention for patients at higher risk of poor functional outcomes using brain imaging (e.g. magnetic resonance spectroscopy in brain tumours, structural MRI for neuropathy), CSF & blood biomarkers and computerized cognitive assessment methods. Interventions under study include repeated transcranial brain stimulation in stroke patients with motor deficits, adaptive deep brain stimulation (DBS) for PD, and an innovative new technique that uses DBS of the anterior thalamus nucleus for drug-refractory epilepsy. A major aim is identification of diseases in their prodromal states – for earlier intervention and to improve long-term quality of life. Recent research has revealed that individuals with RBD (REM or rapid eye movement behavioural sleep disorder) are at 80% risk of developing PD. The Oxford Parkinsons Disease Centre now has the largest cohort of RBD patients in the world. Assessment of this enriched cohort provides an unprecedented opportunity not only for tracking prodromal disease but also development of sensitive techniques to diagnose RBD as well as other conditions, for example, epilepsy, by using remote EEG and sleep monitoring
NDCN has a major interest in Frontotemporal dementia which has clinical overlap with motor neuron disease. We run programs in imaging and wet biomarker discovery as part of the GENFI project and also an internal program called BioMOx
The Centre for the Prevention of Stroke and Dementia, soon to be housed in a purpose built facility is expanding and has a world-leading program in the clinical epidemiology of dementia and stroke risk factors and interventions. It spans both neurology and geratology).
Neuropathology: The Department hosts one of the largest brain tissue collections in the UK, the Thomas Willis Brain Bank, the MRC control brain bank. Research projects include pathology, genetics and microstructure of aging and dementia; neuropathology of movement disorders (MND, Parkinson’s disease, ataxia);in addition to the pathology and genetics of multiple sclerosis; microstructure and post-mortem MRI of autism; pathology of myopathies; and the pathogenesis of glial and pituitary tumours.
Description of the Post
This is a post for up to 3 years duration. The post is for trainees who will be starting in year 3 of their training at the time of commencement of the post (ST3) and is open to trainees in any of the following clinical specialties Neurology, Rheumatology or Trauma & Orthopaedic Surgery.
This is a 75% clinical post with a 25% academic component. Clinical training may be split between Oxford and the regional DGH's. Configuration of the academic component is flexible; the precise configuration will be arranged to accommodate the needs of the project, the appointee and appropriate clinical training.
The ACF will have an academic supervisor and an educational supervisor. Given the array of opportunities on offer, the ACF will have strong mentorship whilst exploring research options during their first year in post, then probably undertake a research block during the second year to obtain pilot data and ultimately prepare a doctoral fellowship application or postdoctoral funding application (if they already hold a doctorate). The 9 months of research will be distributed in the most beneficial way to support the ACF in these goals. At the end of the ACF post in the event that funding for doctoral or post-doctoral work is not secured the appointee will return to full-time clinical training.
TheNeurology Training Programme
The Neurologytraining programme is typically 5 years in duration, starting at ST3. 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 Physicians. The post attracts a National Training Number and provides training towards a Certificate of Completion of Training (CCT) in Neurology.
The Postgraduate Dean has confirmed that the post has the necessary educational and staffing approvals.
The Neurology programme is based at the John Radcliffe Hospital in Oxford, butmay include attachments at Northampton General Hospital, The Royal Berkshire Hospital in Reading, Milton Keynes Hospital and the National Hospital for Neurology and Neurosurgery, London.
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
Royal Berkshire NHS Foundation Trust / RoyalBerkshireHospital, Reading
Northampton General Hospital Trust / Northampton General Hospital
Milton Keynes Hospital NHS Foundation Trust / Milton KeynesGeneral Hospital
University College London Hospitals NHS Foundation Trust / The National Hospital for Neurology and Neurosurgery, London
Rotation Information
Rotations may at times change in response to clinical need from the Trusts. Expected rotation arrangements for this programme are set out below.
In line with the Neurology curriculum 2010 the training period is typically 5 years. An appropriate period of research may be recognised towards training and a trainee might thenspend 4 years in the various posts of the program. Two4 year rotations aregiven below by way of illustration. The order and duration of posts may vary.
Year / First 4 months / Second 4 Months / Third 4 Months1 / Neurology JRH – Neuroscience Ward firm A / Neurology DGH1 / Neurology DGH1
2 / Neurology JRH – Neuroscience Ward firm B / Neurology DGH2 / Neurology JRH – Neuroscience Ward firm C
3 / Neurology JRH – Liaison Post / Neurology JRH – Neuroscience – Outpatient Clinics / Neurology DGH3
4 / Neurology NHNN – Firm D / Neurology NHNN – Firm E / Neurology JRH – Neuroscience Ward Firm A/B/C
Year / First 4 months / Second 4 Months / Third 4 Months
1 / Neurology JRH – Neuroscience Ward firm A / Neurology DGH1 / Neurology DGH1
2 / Neurology JRH – Neuroscience Ward firm B / Neurology DGH2 / Neurology DGH2
3 / Neurology JRH – Liaison Post / Neurology JRH – Neuroscience – Outpatient Clinics / Neurology DGH3
4 / Neurology JRH – Neuroscience Ward firm C / Neurology JRH – Neuroscience Ward firm C / Opportunity to arrange OOPT
Trust Information
Oxford University Hospitals NHS Trust
The Trust is made up of four hospitals - the John Radcliffe Hospital (which includes the Children's Hospital, West Wing, Eye Hospital, Heart Centre and Women's Centre), the Churchill Hospital and the Nuffield Orthopaedic Centre, all located in Oxford, and the Horton General Hospital in Banbury, North Oxfordshire.
OUH provides a wide range of clinical services, specialist services (including cardiac, cancer, musculoskeletal and neurological rehabilitation) medical education, training and research.
Most services are provided in the hospitals, but over six percent are delivered from 44 other locations across the region, and some in patients' homes.
In 2016/17OUH provided care through:
- 1.4 million patient contacts
- 109,317 planned admissions
- 96,273 emergency admissions
- 131,166 emergency department attendances
- OUH also delivered over 8,000 babies.
- OUH employs 12,723 staff (including 3,917 nurses and 1,758 doctors) and its total turnover in 2016/17 was £998 million.
Collaboration with the University of Oxford underpins the quality of the care that is provided to patients; to the delivery of high-quality research bringing innovation from the laboratory bench to the bedside; and the delivery of high-quality education and training of doctors.
Existing collaborations include the ambitious research programmes established through the Oxford Biomedical Research Centre (BRC), funded by the National Institute for Health Research (NIHR), located on the JohnRadcliffeHospital site and at the Biomedical Research Unit in musculoskeletal disease at the Nuffield Orthopaedic Centre.
The West Wing of the John Radcliffe Hospital opened in 2007 and houses the neuroscience disciplines of Neurology, Neurophysiology, Neurosurgery, Neuroradiology, Neuropathology, Neuropsychology and Neurocritical Care. The Rehabilitation Service is at the Nuffield Orthopaedic Centre in Oxford.
Neurology at the OUH NHS Trust:
Consultants:
Prof P RothwellProfessorOxford
Prof K TalbotProfessorOxford
Prof D BennettProfessorOxford
Prof M TurnerProfessorOxford
Prof M HussainProfessorOxford
Prof P BrownProfessorOxford
Dr G De LucaA/ProfessorOxford
Dr Z CaderA/ProfessorOxford
Dr A SenA/ProfessorOxford
Dr C ButlerA/ProfessorOxford
Dr S ManoharA/ProfessorOxford
Dr S IraniA/ProfessorOxford
Dr M HuA/ProfessorOxford
Dr I LeiteClinician ScientistOxford
Dr C BuckleyClinician ScientistOxford
Dr S RinaldiClinician ScientistOxford
Dr G TofarisClinician ScientistOxford
Dr A WebbClinician ScientistOxford
Dr U SchulzNHSOxford
Dr J AdcockNHSOxford
Dr A ParryNHS Oxford
Dr J PalaceNHSOxford/Banbury
Dr D BrileyNHSAylesbury
Dr M JacksonNHSHigh Wycombe/Oxford
Dr S WimalaratnaNHSKettering/Oxford
Dr GLennoxNHSSwindon/Oxford
Dr S HinzeNHSSwindon/Oxford
Other consultants, listed below, work in Oxford and Reading/Northampton/Milton Keynes.
The trainee doctors working in neurology consist of the 3 Neuroscience ward based,one JRH based liaison, and one JRH based Outpatient clinic neurology registrar as well as 7 Neuroscience ward SHOs (F2/CT1/CT2).
The Regional Neurological Service at the JRH comprises the NHS consultants (predominantly Oxford or District Hospital based) and the University Department of Clinical Neurology. These departments are closely integrated. The service encompasses a wide range of sub-specialities including cerebrovascular disease, dementia, headache, movement disorders (including a joint movement disorder surgery team), epilepsy (including a joint epilepsy surgery team), peripheral neuropathy, myasthenia gravis, muscle diseases, and multiple sclerosis. The service includes nationally commissioned (NSCAG) services for congenital myasthenia, neurofibromatosis II and neuromyelitis optica. Within the Department there are currently 18 beds, including two video-telemetry beds, with a further 12 being available on a day-case basis.
There is extensive neuroscience research activity within the NHS and University Department and this includes functional MRI, a neuroscience group investigating ion-channel immunology and molecular genetics, neuropathological research, a stroke group, a collaborative muscle group, MS and epilepsy research and a major recently established Parkinson’s disease research programme. Additionally many interactions exist between other university department and clinical groups within and outside Oxford.
The Neurology trainee posts:
The consultants are currently organised into firms each with a specialty trainee. The time tables for each post include 2 general neurology clinics and subspecialty clinics. Onespecialty trainee works with the consultants to provide a neurology liaison service to the acute medical patients at the JRH and aneurological consulting service to the rest of the hospital and the other hospitals in the trust.A further specialty trainee rotates works in the neurology outpatient department.
Northampton General Hospital Trust
Northampton General Hospital NHS Trust is a large (750 beds) district hospital providing a full range of acute services. The hospital serves a population of 380,000 centred on Northampton but including a mixture of rural and urban areas. In addition to all the secondary care services normally found in a district general hospital, including emergency care, planned care, maternity care, diagnostic and therapy services, the trust provides specialised services for a wider population including a hyperacute stroke service, designated regional cancer services, interventional cardiology, renal medicine and plastic surgery.
Consultants:
Dr K NithiNHSNorthampton
Dr P TomlinsonNHSNorthampton
The neurology and neurophysiology services at NGH provide most of the outpatient neurological service for Northamptonshire as well as support for neurological inpatients at NGH. About 1,500 new and 2000 follow up neurology patients (and over 3000 new neurophysiology patients) are seen in clinic each year.
The registrar programme at NGH runs from Monday to Thursday and is designed to be flexible and to meet the needs of the trainee. Fixed sessions include one new and one follow up neurology clinic a week, regular ward referrals (averaging 8 per week), a medical student teaching session and a weekly grand round (neurology is on the case presentation/image of the week rota). Neurophysiology training is flexible and can be extensive if required (There are two consultant clinical neurophysiologists and 3 qualified technicians). Other flexible experience includes excellent stroke facilities run through the stroke physicians (including thrombolysis), neurorehabilitation, botox clinics, first fit clinics, and headache clinics.
Royal Berkshire NHS Foundation Trust
The Royal Berkshire Hospital serves people across the West of Berkshire and South Oxfordshire; a population of about 550,000. The Hospital has 650 beds and provides services on a single site for all the major specialities including Accident and Emergency, Trauma and Orthopaedics, Intensive Care, Gynaecology and Obstetrics, Genitourinary Medicine, Ophthalmology, ENT, paediatrics (including a NICU), general medicine (including all major medical specialities including CCU, renal unit, 11 bed ITU and gastroenterology), radiotherapy and oncology, and all the general surgical specialities. Comprehensive pathology services are available. The hospital has recently been designated a hyperacute stroke centre.
Consultants:
Dr R Armstrong NHSReading/Oxford
Dr M BogdanovicNHSReading/Oxford
Dr E FlossmannNHSReading/Oxford
Dr A WeirNHSReading/Oxford
Associate specialist: