consultant addiction psychiatrist
ARBD mansionhouse unit
Information pack
reF: 29288d
Closing Date: noon 5th july 2013
www.nhsggc.org.uk/medicaljobs
SUMMARY INFORMATION
Post: consultant addiction psychiatrist
Base: ARBD mansionhouse unit
NHS Greater Glasgow and Clyde Addiction services consist of partnerships between health and social services. The service is now one of the largest and most dynamic substance misuse providers in Europe. It is at the forefront of service developments in many areas including innovative community based treatment and care for individuals with alcohol and/or drug dependency, access to rehabilitation and employment services, and delivering recovery based services.
We are now recruiting a Consultant Addiction Psychiatrist to provide clinical leadership to the Alcohol related Brain disorder team (ARBD) which currently provides a community multidisciplinary assessment and liaison service across Glasgow. The post holder also will provide psychiatric services for East Renfrewshire CHCP including inpatient and day service consultant cover in Kershaw unit at Gartnavel Royal Hospital. This is an addictions specific unit admitting from the South of the river Clyde and the West. The post holder would be responsible for East Renfrewshire community and day patients, and for South Clyde and East Renfrewshire inpatients. The post is line managed by a lead clinician and the Associate Medical Director for Addictions. The postholder would contribute to the general psychiatry on call rota for south of the river Clyde.
Applicants must have full GMC registration, a licence to practice, and be eligible for approval as an s20 MHA approved medical practitioner by the Board. Those trained in the UK should have evidence of higher specialist training leading to CCT in addiction psychiatry or eligibility for specialist registration (CESR) or be within 6 months of confirmed entry from date of Interview. They will require excellent communication and inter-personal skills and should be able to work in partnership with colleagues from other professional backgrounds and with a variety of agencies. An interest in teaching and research is welcomed. Contribution to service development is an important part of the job. Non UK applicants must demonstrate equivalent training
NHS Greater Glasgow and Clyde Addiction Services
Consultant Psychiatrist
10 programmed activities
WITH RESPONSIBILITY FOR PROVIDING AN ADDICTION PSYCHIATRY SERVICE TO THE ALCOHOL RELATED BRAIN DISORDER SERVICE AND TO EAST RENFREWSHIRE
POST REFERENCE No. 29288D
GENERAL INFORMATION FOR CANDIDATES
1. This information package has been compiled to provide prospective candidates with details of the post and background information about the NHS Greater Glasgow and Clyde Addiction Services, which are partnership organisations between the addiction services of NHS Greater Glasgow and Clyde and the addiction services of Glasgow City Council and other local authorities.
2. Informal enquiries and visits will be welcomed by:
Dr John Mitchell, Associate Medical Director, addiction services, templeton business centre, 62 Templeton street Glasgow G40 1DA, tel 0141 277 7660
3. Any offer of appointment is subject to the receipt of two satisfactory references, PVG Disclosure Scotland clearance and a report from the Occupational Health Service.
4. As a Disability Symbol user NHS Greater Glasgow and Clyde recognises the contribution that all individuals can make to the organisation regardless of their abilities.
As part of out ongoing commitment to extending employment opportunities all applicants who are disabled and who meet the minimum criteria expressed in the job description will be guaranteed an interview.
5. Application forms are available in large print for candidates who are visually impaired.
Job Description
General introduction
Increased investment is allowing the creation of a consultant post in addiction psychiatry with primary responsibility for psychiatric input to the alcohol related brain disorder (ARBD) service. In addition, this post would provide psychiatric services for East Renfrewshire CHCP, inpatient RMO work for all South Clyde inpatients who come from addresses in Inverclyde, Renfrewshire and East Renfrewshire CHCPs
The psychiatric services in Glasgow and Clyde are provided by 6 CHCPs. Services are also provided for a small area of NHS Lanarkshire and NHS Argyll and Bute. The Glasgow CHP is split into 3 sectors: North East, North West and South (which also incorporates part of East Renfrewshire). A network of local community mental health centres and clinics exist. There are inpatient facilities at the Southern General, Leverndale, Stobhill, Parkhead, Gartnavel Royal, Vale of Leven, Ravenscraig and Dykebar Hospitals.
This post is part of a NHSGG&C strategy to provide Community Health Partnership (CHP) based addictions services in an equitable way across Glasgow and Clyde. It realises an exciting opportunity for a consultant to create and deliver evidence based services to the population of East Renfrewshire as a whole area and to take an active part in developing an effective service model which ensures service equity and effectiveness across the NHSGG&C ARBD services.
This post is for a full time (10pas) consultant. The job plan consists of 9pas of direct clinical care and 1pas of supporting activity. 1 pa of direct clinical care will initially be dedicated to developing the new role and bedding into systems. Thereafter this pa would be allocated for supporting professional activity in negotiation with the associate medical director.
Beds are provided in kershaw unit at the gartnavel royal hospital site for West Dunbartonshire, South sector, East Renfrewshire, Renfrewshire and Inverclyde and Homeless Addiction Team admissions. There are no specific ring fenced general addiction beds for ARBD. This post holder would be responsible for inpatients from East Renfrewshire, Renfrewshire and Inverclyde with a total average of 7 inpatients.
Day services are available at Kershaw unit for East Renfrewshire and South Glasgow patients. Additional day services are also available at the Alcohol Problem Clinic Dykebar. Traditionally East Renfrewshire patients were either managed through a south Clyde provision via Dykebar APC or through an old Greater Glasgow provision via Kershaw. This post is an attempt to try to create more a single system for medical addiction patient management in East Renfrewshire. The post holder would be expected to facilitate this.
Both inpatients and day patients are medically supported by 1.6 wte speciality doctors who clerk inpatients, provide medical care and create discharge letters. There are occasional trainees.
Comparative distribution compared to elsewhere in Glasgow.
CHCP / population / Combined need = number of problem drug users and alcohol related discharges / Total addiction caseload excluding shared care / Psychiatric consultant medical staffing / Psychiatric SAS medical staffingEast Dunbartonshire / 104580 / 903 / 422 / S Wylie
I smith / F Skelton
G Reynolds
East Renfrewshire / 89540 / 953 / 403 / C Mcmahon
A Hillman
N Bajaj
(this post)
Glasgow NE / 169339 / 8084 / 3307 / M Cooney / A Rizov
Glasgow NW / 198642 / 6275 / 2026 / S Wylie / G reynolds
Glasgow S / 220489 / 6718 / 2412 / B Bajaj SW, A Agnihotri SE / locum
Inverclyde / 79770 / 2376 / 1398 / R sykes
A hillman / R Ashraf
Renfrewshire / 170250 / 3610 / 1499 / C Mcmahon
A Hillman / C Govender
South Lanarkshire / 57000 / Not reported / 149 / A Agnihotri
West Dunbartonshire / 90570 / 2622 / 628 / F Shaw
This post also contributes to the general on call rota for south Clyde, provides potential educational supervision for medical students and a potential training experience for junior and senior psychiatric trainees. Consultant posts also deliver tasks for the broader system. The post holder would need to be eligible to be a Mental Health Act and Adults with Incapacity Act approved medical practitioner and this would be an essential part of the job.
The job :
- 9 pas of direct clinical care to include 4pas of ARBD and 2 pas of East Renfrewshire community addiction psychiatry and 2 pas of South Clyde inpatient cover with 1 pa of development into role. The East Renfrewshire allocated community and hospital based time would also provide RMO cover for any East Renfrewshire day patients.
- 1 pa of supporting professional activity to include time for appraisal, job planning, continuing professional development.
Addiction services for East Renfrewshire
East Renfrewshire Community Addiction Services is a fully integrated service and consists of the Community Addiction Team (CAT) at Tier 3; and Community Recovery Team at Tier 2. The Service has an office base in Barrhead and provides a range of supports and services across the whole of East Renfrewshire operating from approximately 7 different health, social work and local authority, and third sector venues. The Teams provides a full range of services to assist alcohol and drug users to achieve their potential and support their recovery. Services include assessment and care management; substitute prescribing clinics; harm reduction; a wide range of health assessments, including physical and mental health, blood borne virus, medical and psychosocial interventions; moving on services; groupwork; supporting GP shared care, etc.
East Renfrewshire currently has 3 medical officer sessions per week. Their job is primarily around substitute prescribing for complex cases. They are managed by a local senior medical officer. Local GP’s also carry shared care substitute prescribing caseloads supported by the CAT.
There are currently 4 consultants providing varied clinics and access for East Renfrewshire, historically provided by the previous two health boards and responding separately to alcohol and drugs within the old health board areas. These 4 different approaches and consultants will be replaced by this one post.
The consultant psychiatrist postholder would be expected to establish close working relationships with these other doctors and agree collaborative approaches to service provision. The post-holder would be expected to provide psychiatric treatment and review on an outreach basis within identified premises in East Renfrewshire at regular and agreed times.
The Alcohol Related Brain Damage service
The ARBD service currently is based in mansionhouse unit near the Victoria Infirmary. The ARBD team was established in 2006 to provide enhanced services for alcohol damaged individuals from the old greater Glasgow health board geography. It consists of dedicated medical, nursing, social care, psychology, occupational therapy and dietetics input in line with the “Fuller Life “ report (2004).
The ARBD team work in conjunction with service providers (SAMH, penumbra, loretto) who have been commissioned to provide a range of residential placements ranging from very highly supported accommodation to supported living in tenancies. Whilst there are no dedicated addictions beds there is a developing and dedicated rehabilitation pathway.
The consultant addiction psychiatrist would bring medical expertise to the existing team. A significant part of the work is in relation to application of mental health legislation in particular guardianship and capacity assessments. The consultant would act as RMO in this regard for appropriate patients. However patients on the caseload of other services such as general adult psychiatry would continue to have their RMO usually from that service. Negotiation of this on a case by case basis would be important.
Expansion of the service to all of GG&C would be in line with the aspiration of equity of service provision to service users, however this is not currently agreed or financed. South Clyde and West Dunbartonshire currently have separate arrangements. ARBD services for all GG&C are part of an ongoing Clinical Services Review and this post holder would be expected to actively contribute to any proposals for service redesign or expansion.
Other secondary service support
The secondary services support for general addictions in South/ South Clyde include:
- Use of partial hospitalisation service currently in the Kershaw unit at Gartnavel Royal Hospital but possibly moving in the future. Renfrewshire uses a day unit in dykebar hospital and the Renfrewshire drug problem service. Inverclyde has the wellpark centre.
- Admission to psychiatric beds in the Kershaw addictions unit at Gartnavel Royal Hospital as described above.
- 1.6wte specialty doctors provide medical support for all gartnavel Kershaw inpatients and partial hospitalisation patients. These doctors would clerk in all patients, perform physicals, undertake investigations and dictate discharge letters under the direction of the unit consultants. Emergency medical cover is provided by the duty doctor from gartnavel royal hospital psychiatric wards.
- Psychology sessions
- OT input. These provide a functional assessment service and a range of group work programmes.
- Community and residential rehabilitation placement is available through a variety of contracted providers. The consultant would be expected to take a role in the decisions about placement of patients in residential rehabilitation facilities in coordination with the local head of service.
The Duties of the Post
- Inpatient assessment and treatment
ARBD inpatients exist throughout GG&C in acute, mental health hospital beds and in specialist nursing homes. This consultant would not act as RMO for any inpatients but would provide assessment and advice on such inpatients throughout GG&C hospitals. The use of legislation for these individuals would be initiated and done by existing AMP RMOs – the postholder would only provide consultative advice.
The general addiction admissions from South Clyde and East Renfrewshire are mainly for elective alcohol detoxification. Pre admission work up and post admission follow up would be the responsibility of the community teams and their consultants with whom the postholder would need to communicate in terms of agreeing the care plan for a patient through the admission process. Urgent admission can occur, subject to bed availability. These would be negotiated between community consultants and the post holder.
- Day services
Any East Renfrewshire patient attending day services requiring consultant psychiatry input would be the responsibility of the post holder. Speciality doctors in Kershaw currently provide day to day medical cover and complete admission and discharge paperwork.
- Community outpatient clinics and home visits
Psychiatric outpatient assessment and treatment for referred patients with ARBDs and in the general part of the job complex substance misuse problems often in the context of comorbid physical and mental illness. Referrals will generally come from other consultants and from the community addiction teams. Psychiatric emergencies are generally dealt with by crisis and community mental health teams but the postholder would be expected to be flexible in this regard.