HEALTH EDUCATION THAMES VALLEY - SPECIALTY TRAINING PROGRAMME IN OPHTHALMOLOGY (ST1 and above)
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 some 1500 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.
The Ophthalmology Training Programme
The Ophthalmology training programme is a seven year programme, starting at ST1. 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 Ophthalmology. 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 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 / West Wing, John Radcliffe, Oxford,
http://www.ouh.nhs.uk/
Buckinghamshire Healthcare NHS Trust / Stoke Mandeville Hospital
http://www.buckshealthcare.nhs.uk/
Milton Keynes Hospital NHS Foundation Trust / Milton Keynes General Hospital
http://www.mkgeneral.nhs.uk/
Royal Berkshire NHS Foundation Trust / Royal Berkshire Hospital, Reading
http://www.royalberkshire.nhs.uk/
Prince Charles Eye Unit Windsor.
http://www.royalberkshire.nhs.uk/default.aspx
Rotation Information
The rotation is divided into 6 month blocks although most placements are for a minimum of one year. All trainees are expected to rotate to the different hospitals in the scheme. The training requirements are monitored yearly at the ARCP and this will also help plan future placements. All trainees rotate through the Oxford University Hospitals.
As a small school with 23 Specialist trainees on the rotation it is able to provide excellent training in all aspects of Ophthalmology with trainers taking a personal interest in the development of their trainees. The trainees also form a close knit group and are happy to help one another progress. There is a wealth of clinical experience to be gained with plenty of hands on experience and an appropriate level of supervision. All of the sub-specialty areas of ophthalmology are covered allowing advanced trainees to specialise further. Many of the consultant trainers are involved at a national level in training or research and development in their sub-specialty area making the training rotation a particularly enthusiastic one.
The academic department of Ophthalmology in Oxford has an excellent reputation and plays an important part in the clinical school. A Clinical Lecturer post has been established to support liaison between the clinical and academic departments. Opportunities exist for some trainees to take time out to undertake research leading to a MD or PhD. Involvement in research is also encouraged during clinical training.
The school has a website for trainees www.oxeyes.org
Trust Information
Royal Berkshire NHS Foundation Trust
The Royal Berkshire NHS Foundation Trust serves a population of approximately 0.8 million. The Trust provides services to 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 has a mix of light industry, administration and agriculture.
The Royal Berkshire Hospital
The Royal Berkshire Hospital was founded in 1839, the original buildings are still in use to this date and are found to the north of the hospital site. The Hospital became a Trust on 1 April 1992. The Chairman is Mr Colin Maclean, the Chief Executive is Professor Ann Sheen and the Chief Medical Officer is Professor Rachel Hall. A large consolidation project to bring both the Royal Berkshire Hospital and Battle Hospital to one site was completed in 2005.
New facilities include a new main entrance, extension to the South Block including facilities for Orthopaedics, Surgery and Anaesthetics, a new Accident and Emergency department and Battle Block in the centre of the Royal Berkshire site which holds services previously housed at our Battle site and new parking facilities.
As part of Consolidation, a new Clinical Decision Unit (CDU) has opened at the Royal Berkshire site, as a centre of excellence for all medical patients requiring hospital assessment. This is located in the heart of the hospital close to all investigation facilities and the A & E department. There will also be a new Higher Monitoring Area of four beds (HDU) providing experience in non-invasive ventilation, CVP monitoring and step down from ITU.
The Trust is one of the largest employers in Reading with approximately 4,800 staff, with 708 acute beds and 204 day beds across both sites. In 2008 the Eye department treated over 67,000 out patients and performed 12,000 procedures.
Berkshire (Newbury) Community Hospital lies nineteen miles to the west of Reading this was opened in 2005 and incorporates a combined unit for Community Dental Services and Oral Surgery & Orthodontic Services. There are further Community Hospitals in Reading, Henley and Wokingham, with psychiatric services being provided at Prospect Park Hospital, Reading.
Special Services Provided and Training Opportunities
The Eye Department includes a Day-Bed Unit, in-patient beds, 3 operating theatres with video recording facilities, a Lucentis clean room, pre operative assessment suite, casualty department and outpatient facilities.
The out-patient department runs general clinics, specialist clinics and eye casualty, and there are excellent orthoptic, low vision, contact lens and prosthetic services.
The department has equipment for anterior and posterior segment photography, fluorescein and indocyanin green angiography, A&B-Scan ultrasound, corneal topography, ultrasound pachymetry, specular microscopy, optical coherence tomography, Heidelberg retinal tomography and IOLMaster biometry. The clinic rooms have networked facilities for image viewing. There are also Yag, PDT and Pascal lasers in the outpatient department.
There are extensive surgical opportunities for trainees, including micro – incision phacoemulsification ( C-mics, B-mics),23 gauge Vitrectomy, indirect retinal laser, intravitreal therapy, corneal surgery (including penetrating keratoplasty, DALK, DSEK, intacs, stem cell transplantation, cross-linking), endo-nasal DCR with video-imaging and other lacrimal procedures, oculoplastic, strabismus, and glaucoma surgery.
Consultants at the Royal Berkshire Hospital:
Miss A S Bacon - Oculoplastics
Mr P H Constable - Glaucoma
Mr V Tanner - Vitreoretinal
Mr M Leyland - Cornea & ocular surface (Lead Clinician)
Mr A Pearson - Oculoplastics & lacrimal
Miss S-L Watson - Medical Retina (College Tutor)
Miss A. Smith – Medical Retina
Mr A. El-Amir – Vitreo Retinal
Mr Constable and Mr Leyland work at both the Royal Berkshire & Newbury Hospitals, Mr Tanner, Mr Pearson, Ms Smith, Ms Watson, Mr El-Amir also work at Prince Charles Eye Unit, Windsor, Ms Bacon works at Townlands
Other Medical Staff: There are 2 Associate Specialists, 3 Staff Grade Doctors and Fellows in Vitreo retina and Oculoplastics.
The Prince Charles Eye Unit, King Edward V11 Hospital, Windsor
The hospital is situated in the ancient Royal Borough of Windsor with delightful tourist attracting town and country facilities, including the river Thames and Windsor Great Park. The hospital is situated near Windsor Great Park some 2 miles off the M4 and Slough. There is easy access to the town centre, which has good shopping facilities. There are car parking facilities on site.
The Prince Charles Eye Unit, Windsor and the Royal Berkshire NHS Foundation Trust, Reading, together form the Berkshire Eye Service.
The Ophthalmology Unit
The Unit consists of two operating theatre suites with day-case facilities, a Lucentis clean room, an out-patient department and Casualty. There are also outpatient clinics at St Mark’s Hospital.
The Unit is well equipped with modern operating facilities: Stellaris (B and L), Infinity (Allergan) and Signature(AMO) phaco machines, outpatient lasers, glaucoma and retinal diagnostic equipment, and a photographic department run by full-time clinical photographer. Imaging facilities are networked to clinical stations and an electronic patient record and administrative system is used throughout (Medisoft)
Speciality Services provided by the Unit include Surgical and Medical Retina, Paediatrics, Glaucoma Oculoplastics/Lacrimal, Contact lens, Orthoptic and Low Vision.
The Ophthalmology Team
Medical Director Dr Johnathan Fielden (Consultant Anaesthetist RBH),
Consultants
Mr Hildebrand Paediatrics
Miss S Rao Glaucoma
Mr S Kheterpal Medical Retina
Milton Keynes Hospital NHS Foundation Trust
Milton Keynes Hospital opened in 1984 and since that time the town has grown at rapid pace. Our local catchment population now stands at 270,000 and is forecasted to grow to 412,000 by 2031. Milton Keynes Hospital is an ambitious and high performing Trust with a vision to become the hospital of choice for the local population. The Trust achieved Foundation status in 2007 and has maintained its high performance standards, being awarded good/good for use of resources and clinical standards in the Care Quality Commission annual health check.
The Trust’s Vision statement is that:
Milton Keynes Hospital will be the health care provider of choice and committed to treating you well and growing with Milton Keynes.
Milton Keynes Hospital will be recognised to –
§ Be the health care provider of choice
§ Provide excellent services in line with best practice to all patients
§ Deliver patient care in a way that inspires public confidence
§ Respond effectively to the new NHS environment and the growth in the local area
§ Ensure services are grounded within safe systems and processes
§ Value staff by providing an environment where they can develop and grow, being adaptable to change in order to provide a high quality service
§ Develop a performance culture where services are continually reviewed and improved in line with patients
§ To be cost effective and financially secure
Outpatient Clinics
The Ophthalmology Department is a self contained unit which houses the Eye Clinic as well as the Orthoptic and Optometry Departments. The unit also contains the secretarial offices.
The Ophthalmic Unit
This eye department serves Milton Keynes and the immediate surrounding areas. It consists of an out-patient department and day case surgery. In-patients are admitted at Stoke Mandeville Hospital (SMH) at Aylesbury, approximately 20 miles away. The Consultants at Milton Keynes Hospital are part of the Buckinghamshire group of Ophthalmologists consisting of 10 Consultant Ophthalmologists. At Milton Keynes Hospital there is a daycase ward and most eye surgeries are performed, including phakoemulsifcation cataract surgery.
The out-patient eye department is in a self-contained spacious unit with 10 consulting rooms (beside the orthoptic (4 rooms) and optometry (2 rooms) clinical areas) and 2 treatment rooms which are fully equipped. Equipment includes ultrasound A & B scans, YAG and new Argon lasers [with an indirect delivery system], fundus camera, corneal topography and an OCT. There are three part-time Optometrists with contact lens and a Low Visual Aid Service. Three full-time and 3 part-time Orthoptists support the department as well as the Community Orthoptic Screening Service. The Artificial Eye Service is supported within the prosthesis laboratory of the dental department. The ophthalmic secretaries’ accommodation is next to the eye out-patient department.
There is an active teaching programme for junior staff in Ophthalmology across Buckinghamshire, one half-day weekly based at SMH and Oxford Eye Hospital. There is a monthly journal club held at the Department in Milton Keynes. Continuous medical education at all levels is encouraged. There is a monthly regional Ophthalmology audit held at SMH.
This self-contained unit is at present situated within the hospital campus with easy access and parking, and the railway station is nearby (MK to London ~40 minutes).
Specialist Trainees are responsible to Consultant Ophthalmic Staff comprising:
Mr B Kumar Oculoplastics
Mr B Parmar Paediatrics and Strabismus
Mr R Bates Surgical Retina
THE DEPARTMENT OF OPHTHALMOLOGY
Staffing
3 Consultants
2 Associate Specialist Ophthalmologists
2 Specialist Registrars
1 Clinical Fellow
Additional Staff Members
Clinical Fellow
Locum Clinical fellow – not filled
1 OSTs (Oxford Deanery)
ASTO in Paediatric Ophthalmology & Strabismus (in conjunction with Oxford) - not always filled
ASTO in Oculoplastics (in conjunction with SMH) – not always filled
Current Support Team
There are 3 ophthalmic secretaries.
Senior Nurses x 2
Orthoptics
Head Post advertised
There are 6 orthoptists: 3 full-time & 3 part-time with a total of 4.5 WTE
Optometry
Head Optometrist
3 part-time optometrists
Technicians
There are 2 technicians
1 retinal photography and OCT
1 visual field technician
Management
DAVID BOWEN-CASSIE Divisional Manager
Buckinghamshire Healthcare NHS Trust
Buckinghamshire Healthcare NHS Trust was established in April 2003 with the formal merger of South Buckinghamshire NHS Trust and Stoke Mandeville Hospital NHS Trust. A range of clinical networks has evolved to serve the new Trusts population. However, considerable work is being undertaken on the further development of clinical services across the three hospitals and with neighbouring trusts, and this will form the foundation of a possible reconfiguration in the new Trust, subject to public consultation
Population we look after
The Trust serves residents in Buckinghamshire, Thame (Oxfordshire), Tring (Hertfordshire) and Leighton Buzzard (Bedfordshire) - a combined population of 500,000. It serves a much larger population of 1.5m for Burns and Plastic Services and 14m for Spinal Injuries.