OXFORD RADCLIFFE HOSPITAL NHS TRUST STR JD Nov 2008 OxfRdg.… · Web viewStroke medicine has...

OXFORD DEANERYIN 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 John Radcliffe Hospital, 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 the John Radcliffe Hospital, Oxford and 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 322 5290.

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:1. Job Description2. Person Specification - Selection Criteria3. Profile of the Oxford Radcliffe Hospitals NHS Trust

Stroke Trainee (Oxford/Reading) 2

4. Profile of the Royal Berkshire NHS Foundation trust

ABOUT THE PROGRAMMEStroke 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 John Radcliffe Hospital in Oxford is 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 DESCRIPTION for the OXFORD PART of this ROTATION

With the exception of section 10, this job description describes the Oxford component of the rotation, primarily based at the John Radcliffe Hospital. The appointee may also be expected to undertake duties at the Horton General Hospital 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 VACANCYNew posts (1 year, fixed-term)

5. SUPERVISING CONSULTANTS:

Professor Alastair Buchan Dr James Kennedy Dr Ian Reckless

6. EDUCATIONAL SUPERVISORDr James Kennedy

7. PROGRAMME DIRECTOR & REGIONAL SPECIALTY ADVISOR:Professor Alastair Buchan

8. ANNUAL AND STUDY LEAVEAll 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 geratology rota (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 John Radcliffe Hospital. 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 ServiceIn 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 – Horton Hospital)Dr Wilhelm Kueker (Neuro-radiology)Dr Dennis Briley (Neurology)

UniversityProfessor 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, 5 weeks)

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 – Horton Hospital

Tuesday Acute Stroke Unit

Ward referrals

Stroke case presentation / seminarNeuro-radiology review meetingAcute 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

OverviewThe 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 Oxford Brookes University, and hosts nurse and other healthcare professional training.

Performance and activityThe 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 John Radcliffe Hospital, 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 Oxford Eye Hospital. 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 Churchill Hospital 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 John Radcliffe HospitalHeadley Way, Headington, Oxford, OX3 9DUTel 01865 741166

The John Radcliffe Hospital, 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 Churchill HospitalOld Road, Headington, Oxford, OX3 7LJTel 01865 741841

The Churchill Hospital, 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 Horton General HospitalOxford Road, Banbury, Oxfordshire, OX16 9ALTel 01295 275500

The Horton General Hospital, 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.

Organisational structure


The Trust is managed by a Board of Directors which includes:

Chairman Six Non-executive Directors Chief Executive Director of Finance and Procurement Medical Director Chief Nurse,

An Executive team includes the Directors of Operations, Divisional Medical Directors, and Directors of Planning and Information, Human Resources, Estates and Facilities, and the Horton General Hospital.

Trust services are grouped into three divisions, each with a number of directorates. The divisions are responsible for the day-to-day management and delivery of services.The Divisions are:

Division A Division B Division C

Acute and emergency

medicine and geratology – acute general medicine, emergency departments in Oxford and Banbury, and geratology.

Emergency access – operational managers, emergency admissions, and emergency access teams.

Cardiac services – cardiology, cardiothoracic surgery, and cardiac investigative, and diagnostic services

Renal services – urology, renal medicine and dialysis, and transplantation.

Specialist medicine

– dermatology services, Oxford Centre for

Cancer services – medical and clinical oncology, clinical haematology, pain relief unit, and palliative care.

General surgery, vascular and trauma – emergency surgery, gastrointestinal medicine and surgery, endocrine surgery, breast surgery, trauma surgery, and orthopaedic surgery.

Critical care, anaesthetics and Theatres – intensive care unit, neuro-intensive care unit and Horton critical care unit. Anaesthetics provide a service not only within the Trust but also to all other Trusts in Oxford.

Specialist surgery and

neurosciences – ENT, cleft lip and palate surgery, plastics and

Children’s services and clinical genetics – paediatric medicine, paediatric surgery, specialist children’s services, community paediatrics, neonatal, paediatric intensive care, and clinical genetics.

Women’s and sexual

health – obstetrics and maternity services, gynaecology, and genitor- urinary medicine

.Laboratory medicine and

clinical sciences – cellular pathology, biochemistry, haematology, microbiology, immunology, and genetics.

Radiological sciences

– general radiology, CT, MRI, medical physics & clinical engineering, neuroradiology, and


Diabetes, Endocrinology and Metabolism, haemophilia unit, clinical immunology, infectious diseases, and respiratory medicine.

reconstructive surgery, ophthalmology, oral and maxillofacial surgery, neurosurgery, neurology, neuropathology, neuropsychology, and neurophysiology.

nuclear radiology.

Pharmacy and therapies

– pharmacy, physiotherapy, dietetics, speech and language therapy, and occupational therapy.

1.2 Trust Organization

The Trust has organized its clinical and clinical support services into the three divisions, each containing several directorates as indicated above. Clinical Service Units (CSUs) or clinical teams are then grouped into these directorates. Each CSU has a lead clinician (typically a consultant) and a clinical manager. All directorates have a chair and a directorate manager. In addition, corporate services are provided through the Executive Directorates as indicated below.

The Trust also has a Medical Staff Council to which all consultants, associate specialists and consultant scientists belong. Individual directorates will also have consultant groups which will meet on a regular basis.

1.3 Trust Board

Non-Executive Directors

Sir William Stubbs, ChairmanMr Adrian TowseProf Alastair BuchanMs Caroline LangridgeDame Fiona CaldicottMr Brian Rigby

Executive Directors

Chief Executive Mr Trevor Campbell DavisDirector of Finance & Procurement Mr Chris HurstMedical Director Dr James MorrisDirector of Nursing & Clinical Leadership Mrs Elaine Strachan-Hall

Directors attending the Board

Director of Planning and Information Mr Andrew StevensDirector of Estates & Facilities Mr Ian HumphriesDirector of Human Resources Vacant


Divisional Chairmen & Divisional Directors also attend the Board meetings

Divisional Chairman - Division A Dr Hywel JonesDivisional Chairman - Division B Mr Mike GreenallDivisional Chairman - Division C Dr David Lindsell

Director - Division A Ms Moira LogieDirector - Division B Ms Kathleen SimcockDirector - Division C Ms Joanna Paul

This completes the Oxford part of the job description

Specialist Registrar / Specialty Registrar

in Stroke Medicine

Fixed Term – One year

Two Posts

Rotating six-monthlybetween Reading and Oxford


JOB DESCRIPTION

With the exception of section 10, this job description explains the Reading component of the rotation, primarily at the Royal Berkshire NHS Hospital

1. JOB TITLE:Specialist Registrar / Specialty Registrar in Stroke Medicine

2. GRADE:Specialist Registrar / Specialty Registrar

3. SPECIALTYStroke Medicine

4. REASON FOR VACANCYNew post (1 year, fixed-term)

5. CLINICAL SUPERVISING CONSULTANTS:Dr André Van Wyk (Stroke and Elderly Care Medicine)Dr Marco Bogdanovic (Neurology)Dr Andrew Weir (Neurology)Professor Christine Collin (Neuro-Rehabilitation)

6. EDUCATIONAL SUPERVISOR:


Educational Supervisor role would rotate yearly between the 4 local Clinical Supervisors.

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. Neurology Specialist Registrars provide cover on the Stroke unit so that at least one specialist registrar is available every weekday. Annual leave entitlement will be 5 or 6 weeks, depending on the appointee’s seniority.

9. SALARY

Salary will be calculated according the Specialist Registrar / Specialty Registrar scale. The post-holder’s point on the scale will be defined according to seniority and On-Call commitments.

READING PROGRAMME DESCRIPTION:

Stroke Trainee, Reading:

The Stroke Service at the Royal Berkshire NHS Foundation Trust is a consultant-led service with close collaboration between Elderly Care Medicine, Neurology and Neurorehabilitation with the support of on-site Neuro-radiology services. It has close links with other specialties, including Vascular surgery, Cardiology, Gastroenterology including the Nutrition Team and Palliative Care. The Acute Stroke Unit was developed in 2001; in 2007 bed-capacity was increased by incorporating the Acute with Rehabilitation into a combined Stroke Unit

The stroke service is still developing the pathway, care processes and services, in line with the new National Stroke Strategy, launched 5 December 2007. Since 2005, the hospital has had a Rapid Access TIA pathway using the ABCD score. It is envisaged that the ABCD2 score will identify high-risk TIA patients requiring short stay admission for emergency assessment and management for TIA patients. We collaborate closely with Oxford in developing the hyper-acute pathway. Approaches for community rehabilitation for stroke patients are also being developed.

Facilities include:


A daily Rapid Access TIA service (a day-case “one stop shop”): sees lower risk patients with an ABCD score of 4 or below, within 7 days of referral

A combined Stroke Unit of 28 beds (12-14 Acute ASU and 14 -16 Rehabilitation SRU beds)

Specialist Neuro Rehabilitation Unit on Caversham ward (16 beds catering predominantly for the needs of younger stroke pa-tients)

Hyperacute Thrombolysis Service 09.00-17.00 (working hours) Rapid Access TIA service during working week for same-day as-

sessment on ASU of high risk patients using ABCD2 score

The Stroke Service has daily consultant-led ward rounds on the Acute Stroke Unit by consultants in Neurology, Elderly Care and Neuro-rehabilitation.

Trainees will have daily responsibility for patients referred to and treated by the Stroke Service: initial review, ongoing patient-management, ward rounds, coordinated multidisciplinary input, timetabled to provide hyper-acute stroke response team on Mondays and Fridays (whilst on site on other days, appointee can attend for own training purposes, if available); input into the Rapid Access TIA service seeing lower risk patients (on designated duty day). There is currently an ST1 working on the Stroke Unit (backed by Neuro SpR and an ST1) and an F1.

Work Pattern and Team TimetablesThe standard working day is 08.30 to 18.00.Primary focus: gaining an understanding of stroke and TIA and the elements of the seamless service essential to improve outcomes; understanding the impact on patients and those close to them, with measures to support them. In line with anticipated National Stroke Strategy revisions, there will be post adjustments. Post holder is not expected to do any on-call outside the Stroke service.

Base SU ward timetable for Stroke Specialist RegistarMONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY

AM

Combined SUAvW ward round Hyper-acute O/C

Neuro ASU ward roundAvW: Outpatients clinic

Neurorehab ASU ward round

Neuro / Neurorehab meeting thenNeuro ASU and AvW MDT SRU ward round

AvW ASU WRHyper-acute O/C

PM

ASU MDT Ward work

Oxford Stroke and Neuroradiology seminar 17h30 RBH


Neuroradiology meeting

This timetable reflects the working pattern of the Stroke Unit. It is anticipated that 6-7 training sessions will be involved, including the outpatients Rapid Access TIA slot. To meet appointee training needs the other 3-4 sessions will be used for:

regional weekly Oxford training a flexible monthly training rota (2 sessions weekly) with Neurorehabil-

itation providing training in the specialist service spectrum; they in-clude eg. inpatient, case conferences, spasticity management, a stroke FU clinic, occasional HVs and community rehabilitation

remainder: for research, data collection and understanding stroke pathway.

The specialist Neurorehabilitation service offers: training in the special needs of young, working stroke patients, including the psychological and emotional impact of stroke on employment and driving, with spasticity management, and other complex rehabilitation issues.

Also important is audit, research, data collection and understanding the Stroke pathway. There is experience of Palliative Care and developing Community Rehabilitation.

Blank timetable for Stroke Specialist Registar personal planningMONDAY TUESDA

YWEDNESDAY

THURSDAY

FRIDAY

AM

Hyper-acute O/C

PM

The Stroke Unit Is part of the Elderly Care department, within the Division of Medicine.

Elderly Care Medicine is based at the Royal Berkshire Foundation NHS Trust.


The three teams include 3 Specialist Registrars 5 ST1/ST2/F2, 4 F1 and 2 Neuro CMT’s doctors (1 Stroke Unit and 1 Neurorehabiliation (Caversham) ward).

Research, Audit and Service DevelopmentThere are close links for education and research with the University of Reading: the London Road site is less that 50 yards from the hospital. Elderly Care Medicine has Professor Margot Gosney with a research interest and publications in Stroke. Research is encouraged and closely mentored. One session per week can be used for audit, research, personal study, data and guideline development. Links with Neurology, Neurorehabilitation, other specialties, Health Services and PAMS, facilitate research with clinical and laboratory based studies. It is envisaged that all Registrars working in Reading will undertake research of a sufficient standard to be presented nationally and published in peer reviewed journals

Educational FacilitiesThe Royal Berkshire NHS Foundation Trust has a Trust Educational Centre with modern lecture theatre, Microsoft Office computing and audiovisual facilities, seven teaching rooms and a clinical skills facility. A dynamic library includes electronic resources (eg: Athens) accessible from any computer in the hospital via intranet. The library has expressed a strong interest in developing its Stroke reference section.

TeachingAppointee will be encouraged to teach junior colleagues, nurses, PAMS, take an active role in Stroke training, in local and regional seminars and grand round presentations. The stroke curriculum is available online with expected competencies. Specialist Registrars are encouraged to use local, national and on-line facilities to fulfill educational criteria.

MeetingsMonday lunchtime Teaching seminars with Consultants in various

specialtiesTuesday pm: Compulsory Oxford Neuroradiology and case-

based teachingWednesday lunchtime Elderly Care department teachingWed PM Reading G(I)M training afternoonsThursday 12.10 pm – 1.10 pm Grand round

Monthly Regional STR GER teaching and G(I)M Audit Adult Medicine every 2 months and Stroke

service (discuss with Dr Van Wyk and local


consultants)Dr Chatterjee organises Elderly Care departmental audits

AdministrationAppointee will be required to monitor and coordinate leave arrangements of junior doctors.

Background

The Royal Berkshire NHS Foundation Trust serves a rapidly growing population of approximately 0.5 million. The Trust provides services across West Berkshire covering the areas of Reading, Wokingham, Newbury and part of South Oxfordshire. Reading is a University town and a centre for administration and light industry. Wokingham is predominantly a commuter locality and Newbury is predominantly agricultural.

The HospitalThe Royal Berkshire Foundation NHS Trust was founded in 1839. The original buildings are still in use and are found to the north of the hospital site. Following a large consolidation project, new facilities include a new main entrance, extension to “South Block” including facilities for Orthopaedics, Surgery and Anaesthetics, a new A and E department, and “Battle Block” in the centre of the site. The Hospital became a Foundation Trust on 1 June 2006.

Recently the Trust has started talks with Reading University with a view to becoming a postgraduate medical school. The appointment of the Trust's first professors has started this process.

The Trust is one of the largest employers in Reading. In 2004/05 we treated 55,015 inpatients, 28,845 day cases and 333,295 outpatients. 72,632 patients were seen by A&E. The Trust has 3,600 staff (whole time equivalent) 813 inpatient beds (627 acute, 66 paediatric and 120


maternity), 204 day beds and spaces and an annual budget of £228 million.

Services associated with this very large District General Hospital include: -

Medicine: General, Gastroenterology, Renal, Diabetes and Endocrinology, Cardiology, Elderly Care, Stroke Unit, Neurology, Neuro Rehabilitation, Respiratory, Rheumatology, GU, Dermatology, Haematology and Oncology.

Surgery: Trauma & Orthopaedics, General, including Vascular, Urology, ENT, and Oral, and Ophthalmology, Obstetrics & Gynaecology and Paediatrics.

Clinical Support Services: Pathology, Radiotherapy, CT Scanning, MRI, Nuclear Medicine, Radio isotopes, Accident & Emergency, Intensive Care Unit, High Dependency Unit, Clinical Decision Unit.

The PCTs run hospital-based services in Community Hospitals in Newbury, Henley, Wokingham and Prospect Park, Reading. There is Residential Care rehabilitation at Tanfields in Reading and Walnut Close (WILC) in Newbury area. Mental Health Services are provided by a newly formed Trust managing both acute psychiatric and community mental health.

MEDICINE AT ROYAL BERKSHIRE FOUNDATION NHS TRUST

There are four Gastroenterologists: Dr Tony Mee, Dr Margaret Myszor, Dr Jonathan Booth and Dr Jon Simmons (also Nutrition Team), who have their own rota for Gastroenterology emergencies and also participate in the General Medicine take. There are two Endocrine Specialists: Dr Hugh Simpson and Dr Mogah El Sheikh, based in the Diabetes Centre, who also have General Medicine commitments.

The Respiratory team: Dr Chris Davies, Dr Andy Zurek, Dr Ann McGowan and Dr Grace Robinson, also participate in General Medicine take

The Rheumatologists who also do General Medicine, include Dr Jeremy McNally, Professor Anthony Bradlow, Dr Laurel Young and Dr Antoni Chan.

The Elderly Care Medicine department comprises Professor Margot Gosney, Dr David Oliver (Senior Lecturer) and 4 whole time NHS Consultants – Dr Apurba Chatterjee, Dr André van Wyk, Dr Mike Pearson and Dr Janet Lippett; there are 3 Specialist Registrars.

The Stroke Unit is consultant-led with Dr André Van Wyk and five Neurologists: Dr Jane Adcock, Dr Andrew Weir, Dr Marco Bogdanovic and Professor Ralph Gregory and Associate Specialist Dr Saleem Khan with


support from the Neurology SpR. Input from Neurorehabilitation Professor Christine Collin, Dr Hamid Sultan and Associate Specialist Dr Peter Tun,

Neurorehabilitation Professor Christine Collin, Dr Hamid Sultan and Associate Specialist Dr Peter Tun

The Cardiology firm has expanded to five: Dr Nicos Spyrou, Dr Will Orr, Dr Charlie McKenna, Dr Jonathon Swinburn, Dr John Bell and Dr Karen Luxton Associate Specialist. The Cardiologists have no general medical commitments, cover all cardiac emergencies and provide a Cardiologist-of-the-day service to acute medicine. Follow up of acute cardiac problems is by the cardiac firm. There is also on site angiography, pacemaker insertion and facilities for angioplasty and electro-physiological studies. The Renal Medicine department provides a comprehensive renal service: Dr Ramesh Naik, Dr Lindsey Barker, Dr Emma Vaux and Dr Mobin Mohteshamzadeh; they also have General Medicine commitments.

All acute general medical admissions are via the Clinical Decisions Unit. The acute General Medical Physicians participate in a 1 in 16 weekday and a 1 in 16 weekend rota acting as Physician of the Day. All conflicting commitments on this day [Clinics etc] are cancelled and the Physician is expected to see each patient admitted together with a team of junior doctors in order to plan treatment, discharge, or admission to a three-day short stay ward, or to a specialist ward. The Physician is expected to do morning, lunchtime and evening ward rounds, also training junior medical staff. The Elderly Care Medicine Physicians provide a parallel rota to deal with acute geriatric admissions taking in all needs related to admissions over the age of 65. The majority of admissions are medical emergencies direct from General Practitioners; some are admitted from A&E. All go through the Clinical Decision Unit. A four-bedded Higher Monitoring Unit is part of the Clinical Decisions Unit.


RECRUITMENT TO MEDICAL POSTS - PERSON SPECIFICATIONSelection Criteria:

POST: SPECIALIST REGISTRAR / SPECIALTY REGISTRAR IN STROKE MEDICINE

Requirements Essential Desirable

Qualifications/Training(a) What professional qualifications are needed? MRCP or equivalent. Higher degree

(b) What general professional training is needed?

National Training Number (NTN) in one or more recognized parent specialties (neurology, geratology, rehabilitation medicine, general (internal) medicine, acute medicine, cardiology, clinical pharmacology and therapeutics)

Experience(a) What work experience is needed? (b) What type of experience is needed?

Basic Medical Training

On-call experience in acute general medicine (at F2 / SHO level or above) in the last four years

Experience in the use of the NIH Stroke Scale.

Evidence of completed and published primary or secondary research.

(c) What level of responsibility should be shown now?

Ability to make decisions at registrar level

Skills and Knowledge - What special skills or knowledge does the postholder require, eg(a) Knowledge Knowledge of the current policy

context in which stroke medicine operates in England.

(b) Leadership skills Able to work effectively in a multidisciplinary setting.

(c) Organization skills Time management and prioritization skills.

(d) Professional - extra skills or achievements

Experience of teaching or learning in a multidisciplinary setting.

(e) Personal skills Good personal and interpersonal skills

Computing skills: ability to use word processor, spreadsheet and web browser programs.

(f) Communication skills

Good spoken and written English. Communication skills should be highly developed.

Proven ability to communicate in written form

(g) Teaching experience

Experience of teaching. Evidence of excellence in teaching.

(h) Audit experience Experience of routine clinical audit.

Evidence of knowledge of national clinical audit as it relates to stroke medicine.

Other Requirements(a) Interests Demonstrable interest in stroke

medicine and developed career plan

(b) GMC Registration Full(c) Transport Driving LicenceStroke Trainee (Oxford/Reading) 24

Stroke Trainee (Oxford/Reading)

OXFORD RADCLIFFE HOSPITAL NHS TRUST STR JD Nov 2008 OxfRdg.… · Web viewStroke medicine has...

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