Welcome to the HEENW School of ACCS


ACCS Training Programme


The ACCS training programme in Mersey is a two year rotation comprising of six months in each of Emergency Medicine (EM), Acute Medicine (AM), Anaesthesia and Intensive Care Medicine (ICM). There are 22 posts in year one (ST1/CT1). These comprise of 18 posts which have EM as their parent specialty and 4 posts which have Anaesthesia as their parent specialty.

The hospitals within the Mersey region that provide ACCS training include:

Arrowe Park Hospital

Aintree University Hospital

Countess of Chester Hospital

Leighton Hospital

Royal Liverpool University Hospital

Southport Hospital

Warrington Hospital

Whiston Hospital

The Support Team:

Natalie Dawson: - Programme Support Manager

Karen Dorr: - Programme Support Co-ordinator

Michelle Price: - Programme Support Administrator

The Support Team email address:

Dr Thomas Wiles – Training Programme Director –

Dr Roisin Haslett – Associate Dean

North Western

Introduction/Overview of Programme

ACCS provides trainees with an interest in acute specialties with initial training in Acute Medicine, Anaesthesia, Emergency Medicine and Intensive Care Medicine. It is an entry pathway to Anaesthesia, Intensive Care Medicine and both Acute Medicine and Core Medical Training.  Currently ACCS is the only entry point for Emergency Medicine. The North Western Deanery ACCS training programme is a programme of two years duration (CT1 and CT2) and will provide 6 months training in each of the aforementioned specialties.

The specialty of Acute Internal Medicine has one six-month post per rotation. Acute Internal Medicine training is based on the 2016 ACCS Curriculum and allows the trainee to achieve Level 1 competency in Acute Medicine.  An optional third year of Acute Medicine is available for trainees who wish to achieve ST3 competencies prior to ST application.  There are 5 Acute Medicine placements.

CT3 Acute medicine trainees are expected to meet the competencies detailed by the JRCPTB as per this document –

Emergency Medicine comprises of 24 CT1 posts of the ACCS rotation. During their time in this post trainees will be exposed to all aspects of emergency medical practice and will be given a basic grounding in the knowledge and skills necessary for safe practice. The syllabus will be that leading to the membership of the College of Emergency Medicine.  At the end of CT2 trainees are competent to cover the middle grade rota in Emergency Medicine and Emergency Medicine badged trainee’s progress to ST3 year comprising paediatric and musculoskeletal Emergency Medicine.

The Anaesthetic component of the acute common stem is provided at a number of hospitals in the North West. These have been chosen at Trusts where anaesthetic and intensive care training has been of a consistently high standard. For August 2016 there will be 10 CT1 placements. The posts will be for a period of 6 months.

The objective of Intensive Care Medicine component of ACCS is to provide experience in the management of the critically ill patient, in a closely supervised environment.   The ICM competencies outlined in the 2015 ACCS Curriculum are identical to those defined for core training by the Faculty of Intensive Care Medicine and ACCS trainees can apply at ST3 level to the new ICM training programmes.

As of 2016 the selection process differs for each of the tracks (Acute Medicine, Anaesthesia and Emergency Medicine) within ACCS.  There is currently no defined ICM track as ACCS is only one route to Specialty Training in ICM.


General Description of Rotation

ACCS training is offered in many of the hospitals within the Greater Manchester, Cumbria and Lancashire areas of the North Western Deanery. (Please see list below) In most cases training in each of the four component specialties will be offered within the same Trust, but where this is not possible, training will be in two Trusts with geographical co-locations.


Educational Opportunities

There is integrated training across the region for ACCS trainees.


Training Programme


The hospitals within the North Western region that provide ACCS training include:

Blackpool Victoria

Chorley and South Ribble Hospital

Manchester Royal Infirmary

Macclesfield Hospital


North Manchester General

Royal Albert Edward Infirmary

Royal Blackburn Hospital

Royal Bolton

Royal Lancaster Infirmary

Royal Oldham

Royal Preston /Sharoe Green Hospitals

Salford Royal (Hope)

Stepping Hill

Wythenshawe Hospital



Year 1 ACCS – Acute Medicine

Programme Details:

TYPE: Core Training (CT1-CT2 ACCS followed by CT2 CMT)


General Description of Programme:

The Acute Internal Medicine posts have been chosen to afford trainees the following work-based training experience: 1. Clinical and educational supervision by a Consultant Physician who has direct clinical responsibility for acute medicine on-calls (takes). 2. Regular participation and experience in acute medical takes, including responsibility for admitting and managing acutely ill medical patients. 3. Regular out-patient experience in Acute Internal Medicine. 4. Ongoing care for ward-based acute medical in-patients.

Educational Opportunities:

Acute Internal Medicine posts will be supported by teaching programmes at each site. Trainees will be encouraged to not only learn from these formal teaching programmes but also to use the workplace as a resource for experiential learning, with appropriate support and back-up from their educational supervisors and college tutors. For trainees wishing to pursue a career in acute medicine the programme will afford the opportunity to study for the written examinations of the Royal College of Physicians and for such trainees study leave will be encouraged.



Participation in Acute Internal Medicine departmental audit programmes will be expected and supported. As many hospitals in the programmes are University of Manchester teaching hospitals, or affiliated teaching hospitals, teaching medical students may be an opportunity. Teaching and presenting at departmental meetings will be expected. Trainees who wish to publish case-reports or audit work will be fully supported, however the opportunities for original research will be very limited in this programme as the primary aim is attaining Level 1 competencies.


Year 1 ACCS - Emergency Medicine

Programme Details:

TYPE: Core Training (CT1-CT2 ACCS followed by CT3 Emergency Medicine)


Introduction/Overview of Programme:

The objective of the EM component is to provide experience of managing the complete spectrum of emergency presentations in a supervised environment.

The reconfiguration of the delivery of emergency care is underpinned by increased ‘shop-floor’ availability of Consultant and other senior staff in an extended working day. This provides an environment conducive to learning, consequently maximising opportunities for junior colleagues to further develop their clinical skills. In addition, Emergency Departments still provide unique exposure to a wide cross section of patients including paediatric emergencies during the programme.

Colleagues will be afforded the opportunity to function as effective decision makers within the context of the immediate availability of senior colleagues for advice and support.


General Description of Programme:

Trainees will be exposed to critical illness including major trauma and medical, surgical and orthopaedic emergencies in both adults and children. Emergency Departments stabilise and deliver initial care to these patients. This will allow the trainee to be integral to key decision making regarding these patients management with the support of and working alongside senior colleagues.  Emergency Medicine ACCS trainees are placed in Trusts who have Specialist Registrars in EM to encourage a degree of informal mentoring and team building.  These placements are distributed around the North West.

Minor illness and injury experience will also be achieved with the advantage that this will be delivered working with a multidisciplinary team including Nurse Clinicians, Emergency Nurse Practitioners, Emergency Nurses and Allied Health Professionals including physiotherapists and Emergency Care Practitioners.


Educational Opportunities:

The Emergency Department affords unique opportunities for learning in a supervised environment. Shop-floor discussion of case management is integral to the ethos of the speciality and the spectrum of emergency presentations facilitates the delivery of supervised procedures. These will include safe sedation, emergency fracture reduction/joint relocation, pleural aspiration, chest drain insertion, NIV and emergency cardiological procedures including cardioversion. The trainee will also gain initial experience in the delivery of RSI and other critical care interventions. A Regional programme of Core Emergency Medicine training and simulation sessions is delivered largely at Preston and Blackpool.  Trainees will be encouraged to attain appropriate ALS, APLS and ATLS qualifications. The supervised experience within the ED will help in the trainees preparations for post-graduate qualifications.

Emergency Medicine ACCS trainees progress into a third (CT3) year comprising experience in paediatrics and further EM.


Audit underpins the Clinical Governance arrangements of all Emergency Departments. There is current participation throughout EM in national audits detailing the management of asthma, fractured neck of femurs, analgesia delivery, thrombolysis, the administration of antipyretics to hot children and the delivery of antibiotics in suspected cases of meningitis.


Year 2 ACCS - Anaesthesia

Programme Details:

TYPE: Core Training (CT1-CT2 ACCS followed by CT2 Anaesthesia)


Trainees badged as ACCS - Anaesthesia will have an additional year of CT2 Anaesthesia at the end of the ACCS CT1-2 training years.

General Description of Programme:

The programmes are in most circumstances based in a single trust. The intensive care medicine part of the programme is matched in the same year as the anaesthetic post. All the anaesthetic posts are based in busy district general hospitals or teaching hospitals, which have a proven track record of training. The trainees will be treated as new starters to anaesthesia, so will be supervised at all times for the first 3 months of their programme. They will be expected to complete the initial tests of competency during the six month post. This is as laid down in the Royal College of Anaesthetists training programme. After the trainee has attained these competencies, they may join the anaesthetic rota depending on local circumstances.


Educational Opportunities:

All trainees will have an educational supervisor. This may be the local Royal College tutor or another consultant in that department. All trainees will undergo a trust and specialty induction. As with the trainees who are undergoing anaesthetic core training, the trainees will keep a computerised logbook and record of competencies achieved as part of their portfolio. They will have protected half day teaching that is based in the 3 geographical regions of the school (North, Central and South). The teaching is based on aspects of anaesthetic practice that new starters to anaesthesia encounter. There is also plenty of opportunity for one to one teaching in the workplace from consultants or more senior anaesthetic trainees and career grades. Every Trust also runs departmental meetings or journal clubs at which the trainees will be encouraged to participate in and present on topics relative to anaesthesia and intensive care.



Every Trust has a half day audit session. Attendance is compulsory. Trainees will be expected to complete an audit during their placement. The ability to do research is limited, although some trusts have an opportunity for the trainee to become involved with research projects. Every trust on the programme has foundation trainees and medical students. It is expected that the trainee will become involved with the training of other medical and non-medical staff. It is a rewarding part of being a doctor.


CT2 ACCS - Intensive Care Medicine

Programme Details:

TYPE: Core Training


Introduction/Overview of Programme:

Within the North Western region there are 16 Intensive Care Units with recognition for training in intensive care medicine (ICM).The North West ICM training programme is one of the largest in the country and is highly regarded.  The participating units seek to deliver the same excellent training to core trainees.

The objective of Intensive Care Medicine component of ACCS is to provide experience in the management of the critically ill patient, in a closely supervised environment.   ACCS is an ideal route into ST training in Intensive Care Medicine.

General Description of Programme:

Each successful candidate will be based in one intensive care unit for the duration of their ICM attachment. All units participating in the ACCS programme, all of which have been recognised for training in ICM for many years. Although the size and nature of each unit will vary from placement to placement, each trainee will be given the opportunity to manage critically ill patients with a wide variety of medical and surgical conditions.

Further details of hospitals providing ICM training can be found on the deanery and ANWICU websites.

Educational Opportunities:

An FICM Tutor is based in each of the ICM training departments: the tutor will be responsible for providing mentorship and appraisal during each attachment. All units on the programme have a good reputation for the delivery of bedside and informal tuition.

Weekly tutorial programmes by the ICUs in several of the larger hospitals, and it is expected that all trainees will be given the opportunity to participate in one of these teaching programmes during their ICM attachment where one is not available locally.

More formal teaching is also available regionally in a series of Trainee Study Days.   A regular teaching day is held at the Critical Care Skills centre and all trainees are expected to complete a “Transfer” course either during the ICM or Anaesthesia component of their training.


Audit underpins the Clinical Governance arrangements of all ICUs, and all trainees will be expected to participate in this process. Teaching of more junior members of the multidisciplinary team will be encouraged.

16th August, ACCS Induction Day - The Centre at Birchwood Park, 1000-1300, ALL HEENW (Manc’r/Mersey/Lancs)



The Support Team:

Natalie Dawson: - Programme Support Manager

Karen Dorr: - Programme Support Co-ordinator

Michelle Price: - Programme Support Administrator

The Support Team email address:

Jon Argall – Training Programme Director –

Roisin Haslett – Associate Dean


Useful Links: - - ACCS - The Royal College of Emergency Medicine - The Royal College of Anaesthetists - The Royal College of Medicine