Oxford Deanery Specialty Training Programme in Forensic Psychiatry

OXFORD DEANERY SPECIALTY TRAINING PROGRAMME IN FORENSIC PSYCHIATRY

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 Forensic Psychiatry Training Programme

The Forensic Psychiatry training programme is a 3 year programme, starting at ST4. 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 Psychiatrists. 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:

Trusts / Hospitals and Locations
Oxford Health NHS Foundation Trust
/ Littlemore Mental Health Centre, Oxford
Marlborough House MSU, Milton Keynes

Rotation Information –

Rotations may at times change in response to clinical need from the Trusts. Expected rotation arrangements for this programme are: every 12 months.

The Higher Training Scheme in Forensic Psychiatry is based at the Oxford Clinic Medium Secure Unit, Littlemore Mental Health Centre, Oxford, and Marlborough House Medium Secure Unit, Milton Keynes. In addition to the full-time specialist trainees in forensic psychiatry the peer group may at any time include flexible trainees, general psychiatry StRs on a year’s secondment to forensic psychiatry, or research fellows.

A wide and relevant training in forensic psychiatry is offered, including the therapeutic use of containment, security and legislation. The medium-secure units have close links with other services and specialties. Staff as well as patient and public safety has a high priority.

OXFORD HEALTH NHS FOUNDATION TRUST

Training within the Thames Valley Forensic Mental Health Service will occur at the following sites:

MARLBOROUGH HOUSE, MILTON KEYNES

Supervising consultants: Dr Srinivasa Thirumalai

Marlborough House is located on Milton Keynes General Hospital campus. The General Hospital opened in 1984. It is a modern, purpose-built in-patient Medium-Secure Unit which opened in 1989, taking patients mostly from Milton Keynes, Buckinghamshire and Berkshire. Currently there are twenty nine medium-secure beds.

The staff includes three consultant psychiatrists, one or two specialist trainees in forensic psychiatry, one Core Trainee and one SAS psychiatrist. There are two forensic psychologists, nursing staff, occupational therapists, a technical instructor and secretarial support.

There are links with Woodlands House, a low-secure forensic unit in Aylesbury.

THE OXFORD CLINIC, LITTLEMORE MENTAL HEALTH CENTRE

Supervising consultants: Dr Mark Hancock, Dr Susan Hardy, Dr Vivek Khosla, Dr Gautam Gulati, Dr Sukhjeet Lally

Littlemore Mental Health Centre is one of the psychiatric hospitals within the Trust, and is situated to the south of Oxford. The Oxford Clinic, a modern, purpose-built medium-secure unit is situated within the grounds. The Clinic has fourteen acute and sixteen rehabilitation medium secure beds. An adjacent, twenty-bed low-secure unit (Wenric House) and fifteen-bed pre-discharge unit (Lambourn House) is also part of the forensic services, as is a twenty four bed enhanced low secure unit for female patients (Thames House).

Medical staff include eight consultant forensic psychiatrists, three to four full-time StRs in forensic psychiatry, and two or three Core Trainees. The service is sectorized: Dr Lally, Dr Gulati, and Dr Hardy cover Oxfordshire, Dr Hancock covers West Berkshire and Dr Khosla covers East Berkshire. Other staff include clinical and forensic psychologists, occupational therapists, ward-based and community psychiatric nurses and social workers linked to community health teams, plus secretarial support.

Dr Lally is Clinical Director of Forensic & Secure Services.

There is an attached ten-bedded medium-secure unit for learning-disabled patients, which is managed and staffed by a separate Learning Disability Trust. This service could be accessible as a training experience for forensic StRs.

COMPONENTS OF FORENSIC TRAINING

The weekly timetable will be tailored to individual needs following a model of 8 clinical and 2 special interest or research sessions.

The overall training will consist of:

1.The assessment, management, treatment and rehabilitation of patients in a

medium-secure unit

Specialist trainees work under supervision and attend clinical team meetings, management and clinical reviews, and case conferences. They work closely with other disciplines and take a lead in the planning and implementation of treatment programmes under supervision. They will participate in the assessment of patients referred to the secure unit from elsewhere (eg prisons, special hospitals and other psychiatric hospitals).

2.Management of out-patients/liaison psychiatry and the Courts

Trainees accept tertiary referrals from general psychiatrists, and work closely with the Home Office in the case of restricted patients, and with the probation service where patients are subject to probation orders with a condition of psychiatric treatment. Referrals are also taken from the Courts and solicitors. The forensic psychiatry out-patient service is often integrated with the general psychiatry service, and there is an emphasis on good communication with other professionals, including psychologists, probation officers, general psychiatrists, community psychiatric nurses and social workers. Some clinics are held in outlying centres. Trainees are supervised in the preparation of reports and as expert witnesses.

3Prison experience

The forensic psychiatry service at the Oxford Clinic provides a visiting psychiatric service to Bullingdon, Grendon and Huntercombe Prisons. The forensic psychiatry service at Marlborough House provides a visiting psychiatric service to Woodhill and Aylesbury Prisons. The trainee gains experience in the assessment, management and treatment of the mentally disordered in prisons. All work is supervised by the appropriate consultant.

Trainees could have the option of gaining special experience at the HM Remand Centre in Reading.

4.High Security Hospital experience

Broadmoor Hospital provides training in the assessment, management and treatment of patients detained under conditions of high security. At Broadmoor Hospital there is the opportunity to work with a range of possible consultants on different units, depending on the trainee’s particular interests. High Security Hospital experience is usually acquired by day release during the integrated year of training, and the minimum requirement is currently 30 days.

5.Psychotherapy

Trainees are encouraged to develop forensic psychotherapy skills. Psychotherapy supervision for both individual and group work is available under the direction of Dr Steve Pearce in the Department of Psychotherapy in Oxford, which also provides supervision for cognitive analytic therapy.

6.Research

Two sessions a week are allocated to either special interest or research. StRs have the opportunity to undertake research under supervision, and prepare work for publication and presentation at professional meetings. Links with the Oxford University Department of Psychiatry in Oxford facilitate research development. Dr Seena Fazel, who has specific academic sessions, will also assist in developing and supervising research.

7.ForensicAcademic/Teaching

One session per week during term time is allocated to the academic teaching programme. The programme consists of clinical seminars, a journal club and academic presentations by invited speakers. There is also a visits programme.

Attendance at relevant regional and national conferences and training events is facilitated as appropriate. Good library facilities are available.

There are teaching opportunities (medical students and Core Trainees) via the University Department of Psychiatry in Oxford, which organizes a programme for Core Trainees taking Parts 1 and II of the examinations for membership of the Royal College of Psychiatrists. Other teaching opportunities include approved social work training courses, workshops for probation officers and nurses, and teaching ward-based junior doctors.

8.Clinical Governance / Audit

Trainees are expected to take an active role in clinical audit and governance.

9.Management experience

Management experience may be gained in the placements (eg, development and planning committee work, shadowing, etc) and via approved courses. All StRs are expected to attend management training workshops held within the Deanery, or equivalent events elsewhere.

10.Supervision

Trainees have one hour per week of personal supervision with their trainer. Trainers combine the roles of Clinical and Educational Supervisors for StR4-6’s. Each trainee is formally reviewed at three monthly intervals.

11.On-call

The StRs will participate in the General Senior Trainee rota. The on-call experience can include out-of-hours assessments at police stations, domiciliary visits and casualty Mental Health Act assessments. All such work is supervised by the duty Consultant General Adult Psychiatrist and complies with the European Working Time Directive. Approval under Section 12 of the Mental Health Act 1983 is highly desirable. Although there is no specific Forensic on-call rota for StR’s, there are opportunities for those at ST6 level or above to gain experience shadowing the Consultant Forensic Psychiatrist on-call.

Consultant Staff Based in the forensic mental health service

Dr Srinivasa Thirumalai is Consultant Forensic Psychiatrist at Marlborough House Medium-Secure Unit in Milton Keynes.
Dr Jonathan Shapero is Consultant Forensic Psychiatrist at Marlborough House Medium-Secure Unit in Milton Keynes.
Dr Sophie Anwar is Consultant Forensic Psychiatrist at Marlborough House Medium-Secure Unit in Milton Keynes and Woodlands House Low Secure Unit in Aylesbury.
Dr Sukhjeet Lally is Consultant Forensic Psychiatrist at the Oxford Clinic Medium-Secure Unit in Oxford. His clinical catchment area is part of Oxfordshire. He is also the Clinical Director of the service.
Dr Susan Hardy is Consultant Forensic Psychiatrist at the Oxford Clinic Medium-Secure Unit in Oxford. Her clinical catchment area is part of Oxfordshire.
Dr Gautam Gulati is Consultant Forensic Psychiatrist at the Oxford Clinic Medium Secure Unit in Oxford. His clinical catchment area is part of Oxfordshire.
Dr Mark Hancock is Consultant Forensic Psychiatrist at the Oxford Clinic Medium Secure Unit in Oxford. His clinical catchment area is West Berkshire.
Dr Vivek Khosla is Consultant Forensic Psychiatrist at the Oxford Clinic Medium-Secure Unit. His clinical catchment area is East Berkshire.
Dr Rami El-Shirbiny is Consultant Forensic Psychiatrist at the Thames House Enhanced Low Secure Unit for females and Woodlands House Low Secure Unit in Aylesbury.
Dr Julia Cartwright is Consultant Forensic Psychiatrist at the Thames House Enhanced Low Secure Unit for females.
Dr Seena Fazel is a Senior Lecturer in Forensic Psychiatry and Honorary Consultant Forensic Psychiatrist, University of Oxford.

Candidates are encouraged to visit the Scheme by arrangement with the Programme Director:

Contact / Address / Telephone
Dr V Khosla
Programme Director / The Oxford Clinic
Littlemore Mental Health Centre, Sandford Road
Oxford OX4 4XN / 0845 219 1224

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

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 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 pre-employment checks. The employer will confirm their local arrangements, which are expected to be in line with national guidance at

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 and in the national ‘Gold guide’ to Specialty Training at Please ensure that you inform Oxford Deanery of any changes to your contact details.