Academic clinical fellow gets an academic training number, continues the run-through training although in a slower pace. These posts are usually for 3 years and typically include (for a period of one year) 9 months of wards and 3 months of research. However, various combinations exist. Candidates should be in the registrar level.
Guidelines mention that people applying should aim for a higher degree but in reality (London), you get a position only with a higher degree, publications and the rest of the package that gives you the 'x' factor (congratulations Joe!).
Academic clinical fellow and clinical research fellow are not the same.
Academic clinical lecturer is a level up from the academic clinical fellow and typically these posts are created on a basis of external funding from research grants. Working package varies. Consultant level is desirable but not essential. Consultant level is essential only for senior clinical lecturer and higher academic grades.
Finally, you can go to academic medicine without starting from an academic CT1.