OXFORD DEANERY SPECIALTY TRAINING PROGRAMME in General Adult and Old Age Psychiatry

OXFORD DEANERY SPECIALTY TRAINING PROGRAMME IN GENERAL ADULT and OLD AGE 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 the South Central Strategic Health Authority which serves a large population and covers the regions mentioned above as well as the Wessex Deanery areas of Hampshire and the Isle of Wight. 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 General Adult and Old Age Psychiatry Training Programme (Advanced)

The General Adult and Old Age 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 Psychiatry. The posts attract National Training Numbers and provide training towards a single Certificate of Completion of Training (CCT) in General adult or Old age psychiatry.

The Postgraduate Dean has confirmed that this post has the necessary educational and staffing approvals. The programme is based in 3 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:

Trust Hospitals and Locations Oxfordshire and Buckinghamshire Warneford Hospital Oxford Mental Health Trust http://www.obmh.nhs.uk/

Oxfordshire and Buckinghamshire Littlemore Hospital Oxford Mental Health Trust http://www.obmh.nhs.uk/

Oxfordshire and Buckinghamshire Fulbrook Centre, Churchill Hospital site, Oxford Mental Health Trust http://www.obmh.nhs.uk/

Oxfordshire and Buckinghamshire Tindal Centre, Aylesbury, Buckinghamshire Mental Health Trust http://www.obmh.nhs.uk/

Oxfordshire and Buckinghamshire The Fiennes Centre, Banbury Mental Health Trust http://www.obmh.nhs.uk/

Milton Keynes PCT Marborough House, Milton Keynes http://www.miltonkeynes.nhs.uk/

Oxfordshire and Buckinghamshire John Hampden Unit, Stoke Mandeville Hospital Mental Health Trust site, Aylesbury http://www.obmh.nhs.uk/

Oxfordshire and Buckinghamshire Valley Centre High Wycombe Addictions service Mental Health Trust Bucks (SCAS) http://www.obmh.nhs.uk/

Berkshire healthcare Foundation Prospect Park Hospital Reading Trust http://www.berkshirehealthcare.nhs.uk/

Berkshire healthcare Foundation Wexham Park Hospital Slough Trust http://www.berkshirehealthcare.nhs.uk/

Berkshire healthcare Foundation Heatherwood Hospital Ascot Trust http://www.berkshirehealthcare.nhs.uk/

Rotation Information

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

The programme provides approved posts for years ST4-6 in General Adult and Old Age Psychiatry. The programme offers a choice of Specialty and Sub-specialty posts to the 26 trainees who will be on the programme.  General Adult Psychiatry 22  Old Age Psychiatry 10  Eating Disorders 1  Addictions 2  Forensic 2  Psychotherapy 1

Trainees will be expected to spend a year of training in Oxford and a year in Buckinghamshire or Berkshire during the 3 year programme to gain a wide range of experience. Posts are 12 months long and are allocated annually following a process involving both trainees and the TPDs. Trainees will be allocated to an advanced trainer who will provide clinical supervision for the 12 months and in addition an educational Supervisor for the 3 year period of advanced training. The following posts are currently available but the programme annually recruits new advanced trainers through a application and interview process, and currently all trainers receive training and will be appraised in these roles. All NHS Trusts are undergoing service redesign at present and opportunities for developing new training posts will be assessed as the redesigns emerge.

Specialty Location Advanced Trainer Oxfordshire Posts General adult Warneford Hospital, Oxford Denis O’Leary General adult Warneford Simon Hampson General adult Warneford Phil Davison General adult Warneford Rob Bale General adult Warneford Rob Chaplin General adult Warneford Peter Sargent General adult Warneford Digby Quested General adult Warneford Olga Tsatalou General adult Warneford A Molodynski General adult Warneford David Geaney General adult Warneford Julie Chalmers Old Age Fulbrook, Churchill Hugh Series Old Age Fulbrook, Churchill Jane Pearce Old Age Fulbrook, Churchill Lilian Hickey Old Age Fulbrook, Churchill Rebecca Mather Old Age Fulbrook, Churchill Philip Wilkinson Forensic Littlemore, Oxford Rob Ferris General adult/EIP Warneford Janet Patterson Addictions Warneford Gail Critchlow Addictions Warneford Andrew McBride Psychotherapy Warneford Mel Bowden Eating Disorders Warneford Eleanor Feldman General adult Haleacre Amersham, Rajiv Sharma General adult Tindal centre, Aylesbury Sue Thomas General adult Tindal centre, Aylesbury John Baruch Old Age Tindal centre, Aylesbury Brian Murray Rehabilitation/AO Tindal centre, Aylesbury K Dauncey T General adult Tindal centre, Aylesbury Lesley Robertson Forensic Milton Keynes S Thirumalai General adult Valley Centre High Wycombe Nicky Crowley Addictions Sefton House, Valley Centre, High Wycombe Alistair Reid General adult Wexham Park, Slough Liz Clifford Old Age Wexham Park, Slough Eastwood General adult Prospect Park Hospital, Reading Farooq Ahmad General adult Wokingham/community & Prospect Park Hospital Jane da Roza Davis General adult Newbury community Farzana Abid General adult Newbury & Prospect Park Hospital Flavia Leslie Old Age Wokingham & Prospect Park Hospital Jackie Hussey Old Age Newbury & Prospect Park Hospital Matt Evans

Trust Information OBMH

OBMH, a Foundation Trust since 2008, provides mental health services to Oxfordshire and Buckinghamshire and also provides specialist services eg children and adolescents and eating disorders, further afield, in Bath and North east Somerset and Wiltshire. The Thames Valley Forensic Mental Health Service based in Oxford provides a forensic service to Oxford, Bucks and Berkshire and Milton Keynes. OBMH serves a population of 1.1 million. It is organized around seven directorates. Trainees on the programme may work at any of the following hospital sites but in addition community services are delivered from a number of community sites and bases, not listed here:

 Links to hospital websites (Deanery to complete)

Littlemore Mental Health Centre, Oxford This is the site of one male 22 bedded general psychiatric ward (Phoenix ward), the Intensive psychiatric care unit (Ashurst ward) and is also the site for the various forensic services. A number of inpatient services are provided in separate units ie Oxford Clinic (medium secure), Wenric House (low secure), Thames House (a service for swomen) and Lambourn House, pre-discharge unit. There are opportunities for general adult trainees to spend special interest sessions or a year in the forensic service. There is a separate rotational higher training scheme in forensic psychiatry.

Warneford Hospital, Oxford A general psychiatric hospital with 3 acute admission wards. It is also the site of the Early intervention service, an out-patient department, a day hospital and an occupational therapy department. There is an excellent library, the Clinical Psychology Department, the Psychological therapies Department and the Highfield Family & Adolescent Unit are on site. The university department is on this site as well as a number of research facilities.

The Fulbrook Centre, Churchill Hospital, Oxford A general hospital with two in-patient assessment and treatment units for older adults

The Fiennes Centre, Banbury A 17 bedded inpatient assessment and treatment unit for older adults Malborough House, Milton Keynes A medium secure forensic unit.

Tindal Centre, Aylesbury A general psychiatric unit with two acute wards and two of the three mid- Buckinghamshire CMHTs. Low secure and open rehabilitation units, namely Woodlands House and Mandalay House, the inpatient beds for the Buckinghamshire early onset dementia service, the bases for Assertive Outreach, Early Intervention in Psychosis and Community Drug and Alcohol Teams and the Cornerstone Day Service are on the adjacent Manor House site. A liaison service is provided to Stoke Mandeville Hospital which includes the National Spinal Injuries Centre.

John Hampden Unit, Aylesbury A progressive, well-established, community-oriented department of old-age psychiatry, serving Aylesbury Vale and West Hertfordshire and located on the Stoke Mandeville Hospital site. It is committed to a flexible approach to the assessment and management of patients over 65 years of age with mental health difficulties, and offers wide-ranging therapeutic opportunities. There are close links with the physicians and surgeons at Stoke Mandeville Hospital, which are mutually valued.

The total population served by the Unit is approximately 31-32,000. There are three community teams, the one relevant to this placement having a catchment area population of about 15-16,000.

The inpatient areas comprise a 21-bed dementia ward (with both assessment and respite beds) and a 13-bed functional illness ward. There is a day hospital serving both functional and organic patients on the site, and a day unit at Buckingham Hospital.

The multidisciplinary team includes psychologists, CPNs, health care assistants, occupational therapists, OT technical instructors, and a medical secretary.

Trust information: Berkshire Healthcare Foundation Trust A Foundation Trust since 2007, BHFT provides mental health services to Berkshire and services are organized across 6 localities alongside the unitary authorities (Reading, Wokingham, Newbury, Slough, Windsor and Maidenhead and Bracknell). Currently consulting in the process of re-design (Next generation Care) to meet the changing needs of the population in the current financial climate.

 Links to hospital websites (Deanery to complete)

Heatherwood Hospital A general hospital in East Berkshire. Also site of mental heath services for Windsor Ascot and Maidenhead which are provided on ward 12, an adult 25 bedded inpatient unit, mother and baby and eating disorders unit. Ward 14 provides in patient services for older adults from Windsor Ascot and Bracknell and the outpatient facility is on the same site. Wexham Park Hospital A general hospital in Slough, East Berkshire. Inpatient mental health adult services provided on ward 10.

St Mark’s Hospital Maidenhead Inpatient services for older adults for Slough Maidenhead (Charles Ward)

Prospect Park Hospital, Reading Prospect Park is a purpose built general psychiatric hospital, opened in 2003, that provides in-patient services for the West Berkshire population of approximately 550,000 and a PICU for the whole of Berkshire.

The service is divided into three localities, Reading, Wokingham and Newbury. There are general adult training posts in each of these localities providing opportunities for inpatient and CMHT based community experience. There is a substance misuse service based in Reading providing opportunities for special interest sessions.

There are fully-developed assertive outreach and crisis services in all localities. There is a 7-day deliberate self harm liaison service and a 9pm to 9am overnight mental health crisis service based at the Royal Berkshire Hospital, Reading.

There are two old-age psychiatry placements at Prospect Park Hospital, one covering Newbury with Dr Evans, the second covering Wokingham with Dr J Hussey. The work combines in-patient and community assessment and treatment of both functionally and organically disturbed elderly patients. There is also a developing service for patients with pre-senile dementias. The service is multidisciplinary in nature with community day hospitals.

Teaching

In both Trusts there are well established weekly academic programmes attended by trainees and medical staff, in protected time. There are many additional opportunities to attend other postgraduate meetings in the University Department in Oxford. Both Trusts have excellent training departments with opportunities to participate in multi-professional training. There are opportunities to train in various psychological therapies under supervision.

Duties of Post

Clinical duties The clinical duties in each post will vary according to the type of service being delivered by the consultant but across the whole programme a wide range of clinical experience is available. The out of hours service provision is being reviewed in both Trusts and the opportunity to be on an on-call rota varies and may change.

Management and administrative skills There are opportunities both in each post and across the programme. There are opportunities to represent the junior staff on several committees at Trust and Deanery level. The Oxford Deanery is committed to providing management training for specialist trainees in the course of their rotations.

Teaching others There are opportunities to teach medical students from Oxford and Southampton medical schools, foundation and core trainees from the Oxford deanery, and other professionals in multi-professional settings.

Research and audit There will be widespread opportunities to meet audit and research competencies. The Programme has close links with the University of Oxford through the Department of Psychiatry based in Oxford. Currently the psychiatry programmes also includes ACF and ACL trainees who apply through a different route but who rotate alongside their clinical trainee colleagues to ensure clinical competencies are achieved in the same way. In addition 2 trainees are currently pursuing an MA in Education The University Department has wide research interests and a number of NHS consultants are honorary clinical lecturers who are active in research.

In Berkshire there are links to Reading University, including the Charlie Waller Institute of Evidence-Based Psychological Treatment.

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, 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. http://www.nhsemployers.org/PlanningYourWorkforce/MedicalWorkforce/EWTD/P ages/EWTD.aspx

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 http://www.nhsemployers.org/PayAndContracts/Pay %20circulars/Pages/PayCircularsMedicalandDental.aspx

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 http://www.nhsemployers.org/PayAndContracts/Pay %20circulars/Pages/PayCircularsMedicalandDental.aspx . 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 http://www.nhsbsa.nhs.uk/pensions

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 http://www.nhsemployers.org/PAYANDCONTRACTS/JUNIORDOCTORSDENTISTS GPREG/Pages/DoctorsInTraining-JuniorDoctorsTermsAndConditions150908.aspx

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 http://www.nhsemployers.org/PAYANDCONTRACTS/JUNIORDOCTORSDENTISTS GPREG/Pages/DoctorsInTraining-JuniorDoctorsTermsAndConditions150908.aspx. 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 http://www.nhsemployers.org/RecruitmentAndRetention/Employment- checks/Pages/Employment-checks.aspx

Professional registration – it will be a requirement of employment that you have professional registration with the GMC 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 www.oxforddeanery.nhs.uk and in the national ‘Gold guide’ to Specialty Training at http://www.mmc.nhs.uk

December 2010