North West School of Surgery - Oral and Maxillo-Facial Surgery, West Sector (Mersey)

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North West Oral and Maxillo-facial Surgery

Cheshire and Merseyside

OMFS Overview OMFS East Sector OMFS West Sector OMFS ARCPs

Information on this page relates to the West Sector of NHS England – North West (Cheshire, Merseyside and North Wales).

For information on the East Sector (Greater Manchester and Lancashire), please click here.

Important: Please Note

Two ST3+ posts are Welsh NTNs and recruited at national recruitment through Health Education and Improvement Wales (HEIW - formerly the Wales Deanery) as ‘North Wales rotation’ but these posts are within the Cheshire, Merseyside and North Wales rotation.

From August 2022 HEIW are also recruiting an ST1 run-through post as 'North Wales rotation' - this will be based in North Wales for ST1/2 before running through into the Cheshire, Merseyside and North Wales rotation from ST3.

Key Contacts

Mr Sherif Bayoumi,
OMFS Training Programme Director

Based at North Manchester General Hospital
Email: sherif.bayoumi@mft.nhs.uk

OMFS Cheshire, Merseyside and North Wales Rotations

There are 11 ST3 and above training posts in OMFS in this rotation including one academic clinical fellow (ACF) post. There is in addition to one ST1/CST1 ‘run-through’ post.

The ST3-7 training rotation includes one of the largest hub units with 15 trainers all with sub-specialty interests, a children’s hospital with supra-regional craniofacial and cleft surgery, and district general hospitals including North Wales which includes rural practice.

Clinical opportunities for training are exceptional with the opportunity to exceed the indicative numbers defined by the SAC OMFS, and the option of concentrating on sub-specialty training once these competencies have been achieved.

Doctors will spend approximately four years in Aintree and Alder Hey Children's Hospital and one year in Arrowe Park and North Wales during the five year programme. Rotations consist of training blocks of 4-6 months duration. Training blocks are allocated by the Training Programme Director (TPD) in the context of the doctor’s learning needs. The range of blocks mean that each doctor receives exposure to the entire spectrum of the specialty and this exposure is graded so that a doctor in training is not exposed to too much responsibility, but a more experienced doctor in training is prepared for life as a consultant.

Outline of Clinical Training

Hospitals

Aintree University Hospital part of the newly formed Liverpool Universitiy Hospitals NHS Foundation Trust is the hub hospital in which OMFS training in the old Mersey Deanery area of NHS England – North West is based. Doctors rotate around the region and to North Wales to ensure exposure to the full OMFS curriculum. Aintree has the largest team of OMFS consultant/trainers in the UK. It has a world leading team in Head and Neck Cancer surgery, with strong links to ENT colleagues. Liverpool has one of the busiest OMFS trauma services, five surgeons with sub-specialty interests in facial deformity including orthognathic surgery two of whom also are recognised trainers in the Interface Aesthetic Surgery Fellowships. Aintree provides regional services for facial skin surgery, basic and complex dentoalveolar surgery under LA and GA, TMJ surgery including TMJ replacement, as well as a district service for its local community.

Alder Hey Children's Hospital (One ST) is the largest children's hospital in Europe. It is the North West Regional Cleft Lip and Palate Service (in a functional network with Manchester). It is one of the five Supra-regional Craniofacial Units in the UK managing syndromic and non-syndromic anomalies, and provides exposure to general paediatric OMFS including paediatric head and neck malignancy.

Arrowe Park Hospital (One ST) is part of Wirral University Teaching Hospitals NHS Foundation Trust area south of the river Mersey and provides training in OMFS service provision in a spoke DGH to a central hub. It offers a general maxillofacial service including salivary gland surgery, dentoalveolar surgery, adult facial deformity in addition to a busy facial skin cancer service. Most trauma is transferred to Aintree depending on the complexity of the case and availability of surgical/theatre time. There is also an opportunity to observe facial aesthetic surgery.

Doctors based in the regional unit and the hospitals above provide an out of hours service on a 1 in 8 basis minimum.

North Wales

Glan Clwyd Hospital part of Betsi Cadwaladr University Health Board across North Wales, – is a district general hospital which provides a regional OMFS service to the people of North Wales. It provides the full range of OMFS services except primary cleft and craniofacial surgery. There is a separate on-call rota of 1 in 5 based in North Wales.

It serves as the hub of the North Wales Oral and Maxillo-Facial surgery service. It provides general and specialised out-patient services in addition to day case and in-patient surgery. The department shares a dedicated 27 bed Head and Neck ward with ENT.

Four spoke hospitals are situated at Bangor, Deeside, Llandudno and Wrexham providing out-patient clinics and day case surgery. Patients requiring in-patient stay are transferred to the main unit at Glan Clwyd. Approximately 40 microvascular free flaps are performed annually, and the department provides a reconstruction service for ENT. Multi-disciplinary meetings are held for head and neck cancer, dermatological malignancy, adult facial deformity and restorative/implant dentistry. There is a very large facial skin cancer workload. The unit possesses sialoendoscopy equipment for the minimally invasive management of salivary gland calculi and strictures.

Opportunities to Visit

Each month there is a regional audit and teaching day at Aintree at which most of the doctors in training and trainers are present. Prospective applicants are invited to contact the TPD to arrange a visit.

This is an academic unit with 2 university-based consultants and a high research output.

Travelling Between Hospitals

Apart from on-call activity (when doctors working in a spoke hospital have to return to the hub), there are very few days during which doctors are required to be in two hospital locations. The exceptions are joint clinics in Liverpool Dental Hospital and Chester.

Hospitals on the Oral and Maxillo-Facial Surgery East Sector Rotation

Site	Trust
Aintree University Hospital	Liverpool University Hospitals NHS Foundation Trust
Alder Hey Children's Hospital	Alder Hey Children's Hospital NHS Foundation Trust
Arrowe Park Hospital	Wirral University Teaching Hospital NHS Foundation Trust
Glan Clwyd Hospital	Betsi Cadwaladr University LHB

GMC Programme Code: NWE1130 (was MER934) and NWE1165 (run-through - was MER2549)

Educational Programme

University of Liverpool Masters in OMFS

Liverpool is unique in offering a 4 year OMFS Masters Degree programme which all 23 NHS England – North West doctors (inc ST1/2) are invited to join and funded from the study budget. This forms the regional teaching programme with 4 20 credit modules rotating over a 4 year cycle with additional credits delivered in the Liverpool Microvascular Course and additional optional modules. The full masters award requires submission of a dissertation at an additional cost. This programme led by Prof Richard Shaw and covers all aspects of the OMFS curriculum and FRCS syllabus. There are annual OSCEs and assignments as part of this programme aiding preparation for the exam in ST6 and also helping doctors meet the CCT requirement for presentations and publications.

NHS England – North West also offer funded modules on the Edge Hill University PGCert in Teaching and Learning in Clinical Practice course and also in Leadership and Management. These academic module credits have the ability to be transferred and can be combined to the UoL programme. All new ST3 doctors will be offered a NOTTS course and many other regionally arranged teaching courses which also have opportunities to teach and be part of the faculty.

On the academic side Liverpool has two professors in OMFS and a senior lecturer who supervises our academic doctors in training and all have supported OMFS doctors complete research qualifications including PhD and MD. A recent paper showed that Cheshire and Merseyside doctors in training also lead the country in the conversion of abstracts/presentations to full papers. This shows the focus and the support a doctor may expect in completing projects and getting published.

On-Call

Liverpool

Currently the on-call for STs is a 1:8 with prospective cover. This can vary to include additional rota members such as craniofacial, cleft or H&N fellow.

When on-call, the ST covers the Merseyside and Cheshire region with patients travelling to the hub hospital. There is a Consultant of the Week for trauma and emergencies with 6 dedicated OMFS trauma operating lists including all day Sunday.

North Wales

Currently the on-call for STs is 1:5. The on-call is centred in Glan Clwyd is less busy than in Liverpool, but the range of activity is different covering a large rural area from Bangor to Wrexham.

Special Interest

Surgical Dermatology and Lasers

A large volume of skin lesions is treated annually as well as vascular lesions of the head and neck. There is a large volume management of skin malignancy has been a growth area for OMFS surgeons in recent years. In the West Sector, Mark Boyle, Carl Jones and Robert Laycock are the main providers of this service. Skin cancer in Liverpool has its own Multi-disciplinary Clinics (MDT) attended by these clinicians. The OMFS team in North Wales provide the skin cancer service and thus a wealth of experience and all the consultants are involved in providing this training. MDTs exist in each hospital in North Wales.

Dento-Alveolar Surgery

There is adequate exposure to this core activity of our specialty and those entering training with low exposure receive targeted training in this area. This does not detract from the training opportunities in other sub-specialty areas. More complex dentoalveolar surgery is referred from Liverpool Dental School to Aintree for further care.

Aesthetic Surgery

This will become an increasingly important part of private practice in the future. As the majority of surgery in this sub-specialty area is undertaken in the private sector, most ST rotations find it difficult to deliver advanced experience for the interested doctor. In Liverpool there are opportunities in the NHS and in the private sector to develop skills and knowledge in this area. A recent doctor in training obtained a place on a rhinoplasty fellowship, the first UK OMFS postgraduate doctor in training to do so.

Combined Care with Neurosurgery

The Walton Centre for Neurosciences based on the same site as Aintree Hospital. There is a skull base MDT and joint operating on both oncology, trauma and adult craniofacial patients on a regular basis.

Trainers

Cheshire and Merseyside

Name	Hospital(s)	Sub-Specialty Interest
Andrew Schache (AS)	University of Liverpool
Andrew Schache (AS)	Aintree University Hospital	Oncology
Anne Begley (AB)	Aintree University Hospital	Adult deformity
Anne Begley (AB)		TMJ, Salivary
Carl Jones (DCJ)	Arrowe Park Hospital	H&N skin cancer;
		Adult deformity, Trauma
		Aesthetic surgery
David Richardson (DR)	Aintree University Hospital	Ear Reconstruction
	Supra-regional Craniofacial Unit	Craniofacial
	Countess of Chester Hospital	Adult deformity
Fazilet Bekiroglu (FB)	Aintree University Hospital	Oncology
Fazilet Bekiroglu (FB)	Leighton Hospital Crewe
James Brown (JSB)	Aintree University Hospital
James Brown (JSB)	Warrington Hospital	General OMFS
Katharine Fleming (KF)	Countess of Chester Hospital
Katharine Fleming (KF)	Aintree University Hospital	Deformity/General
Mark Boyle (MAB)	Aintree University Hospital	Adult deformity Skin
Mark Boyle (MAB)	Southport and Ormskirk Hospitals	Aesthetic surgery
Martin Dodd (MD)	Aintree University Hospital	Adult deformity TMJ
Martin Dodd (MD)	Whisotn Hospital	General OMFS
Owais Khattak (OK)	Aintree University Hospital	Oncology
Patrick Magennis (PM)	Aintree University Hospital	Trauma
Patrick Magennis (PM)	Liverpool University Dental Hospital	General / TMJ
Prof Richard Shaw (RJS)	University of Liverpool
Prof Richard Shaw (RJS)	Aintree University Hospital	Oncology
Robert Laycock (RL)	Aintree University Hospital	Skin surgery, Adult deformity inc post traumatic, Aesthetic surgery
Prof Simon Rogers (SNR)	Aintree University Hospital	Oncology
Prof Simon Rogers (SNR)	Edgehill Univeristy
Simon van Eeden (SVE)	Alder Hey Regional Cleft Unit	Paediatric Cleft
Simon van Eeden (SVE)	Aintree University Hospital	Adult Cleft / Deformity
Stanley Parikh (SP)	Arrowe Park Hospital	Deformity, general OMFS
Stanley Parikh (SP)	Aintree University Hospital	Trauma

North Wales

Name	Hospital	Sub-Specialty Interest
Christopher Lloyd (CL)	Glan Clwyd	Oncology/General
Christopher Penfold (CP)	Glan Clwyd	General
Emma Woolley (EJW)	Glan Clwyd	Adult Deformity/General
Huw Jones (HJ)	Glan Clwyd	Oncology/General
Anil Kamisetty (AK)	Glan Clwyd	General / Skin

Linked non-OMFS 'trainers'

Name	Hospital	Sub-Specialty Interest
Chris Butterworth (CB)	Aintree University Hospital	Restorative / Implants

Fellowships

Training Interface Fellowships (TIG) and Craniofacial Fellowship

Within Liverpool here are also fellowships available in:

Paediatric Craniofacial Surgery
TIG Cleft
TIG Aesthetics (contributed to)

NIHR Academic Clinical Fellow with NTNa

Professor Shaw supervises the Academic Clinical Fellow. This is not a recurring post but will be reviewed when the current post finishes. This post is 25% research 75% clinical and although benchmarked through national recruitment is separately recruited to.

Links

Liverpool Research Links

Liverpool Clinical Trials Unit