Consultant General Adult Psychiatry EARLY

consultant general adult psychIatry EARLY

intervention psychosis (ESTEEM)

northeast glasgow

Information pack

reF: 33345d

Closing Date: noon 20th June 2014

SUMMARY INFORMATION

Post: consultant IN GENERAL ADULT psychiatrist

Base:hydepark business centre, north east glasgow

Applications are invited for a 0.6 wte Consultant Psychiatrist for the Early Intervention Psychosis Service (Esteem) within North East Glasgow. North East Glasgow has mixed deprivation, with a mixture of deprived inner city areas and affluent suburbs. Inpatients are currently admitted to Parkhead and StobhillHospitals but it is expected that all admissions would eventually come to StobhillHospital as services are reconfigured.

The Early Intervention Team and the successful applicant would be based together at Hydepark Business Centre. They would be supported by specialty grade sessions and the multi-disciplinary Esteem team. It is expected that the successful applicant would work closely with their Community Mental Health Teams, Social Work and Voluntary Organisations to provide a comprehensive service, including inpatient and outpatient treatment, working as part of a multidisciplinary team. They will participate in the on-call rota and cover for colleagues during absences in line with arrangements set out in national Terms & Conditions. It is expected that the successful applicant would be an Approved Medical Practitioner in terms of the Mental Health (Care & Treatment)(Scotland) Act 2003 by the time of appointment.

The Early Intervention Service is a well-established model in Glasgow. It targets all new presentation of psychotic illness and provides continued input for the first 2 years. The aim is to provide maximum functional recovery during this period and improve longer-term outcomes. It is expected that the Esteem Service in North East Glasgow will work closely with carers and provide psychosocial interventions where appropriate. The service model is based on early intervention philosophy and the Glasgow Integrated Care Pathway for Psychosis. The aims are to minimise the duration of untreated psychosis, minimise trauma, promote recovery and functional outcome and provide support to families. It is expected that there will be a 15:1 caseload for key workers and that members of staff provide an active occupational therapy programme and psychosocial interventions, including family work and cognitive behavioural therapy.

Applicants must have full GMC registration and a licence to Practise. Those trained in the UK should have evidence of higher specialist training leading to CCT or eligibility for specialist registration (CESR) or be within 6 months of confirmed entry from date of Interview.

CONSULTANT IN GENERAL ADULT PSYCHIATRY

EARLY INTERVENTION IN PSYCHOSIS (ESTEEM)

NORTH EAST GLASGOW

Job Description

CONSULTANT GENERAL ADULT PSYCHIATRIST

EARLY INTERVENTION IN PSYCHOSIS SERVICE (ESTEEM) – NORTH EAST GLASGOW

Applications are invited from a dynamic and enthusiastic individual for this exciting 6 session General Adult post based in North East Glasgow. The successful applicant would be expected to lead a multidisciplinary team providing an intensive service to 16-35 year olds with a Early Intervention Psychosis. The successful applicant will be supported by a multidisciplinary team, including Staff Grade sessions, Clinical Psychology sessions, 1 Support Staff and 5 Community Psychiatric Nurses/Occupational Therapists or equivalent. It is expected that caseloads will be around 1 member of staff per 15 patients. The Service will look after patients for first 2 years after diagnosis. The in-patient beds are based currently in Parkhead and Stobhill hospitals and the community base is in the Hydepark Business Centre, Springburn. The successful applicant will be expected to work closely with colleagues to provide a full range of services to inpatients and outpatients suffering from their first psychotic episode.

Present Service Provision

Current Psychiatric Services – North East Glasgow Area

The Psychiatric Services in Glasgow are split into three areas of a city wide Mental Health Service; two areas North of the River Clyde and one to the South. The North East Glasgow area lies between the River Clyde to the South, the River Kelvin to the West and the Campsie Hills to the North. It covers a population of approximately 350,000 with areas of significant deprivation. Community Services in North East Glasgow are well developed. The general adult services are provided by Community Mental Health Teams based in 6 community resource centres:

Kirkintilloch Health and Care Centre/ Strathkelvin Locality (G33, G65, G66, G69), population 85,000.

Springpark Centre / Springburn/Possil Locality (G21, G22, G33) population 50,000

Shawpark Centre / Maryhill Locality (G3, G4, G20, G23) population 53,000

The Acute Adult Inpatient beds are presently located on 2 sites: (i) MacKinnon House on the Stobhill GeneralHospital site and (ii) ParkheadHospital in East Glasgow.

Arran Centre / City Centre Locality (G1, G2, G3, G4, G21, G31, G40) population approx 50,000

Anvil Centre / Mid Sector Locality (G32, G33) population approx 50,000

Auchinlea House / East Sector Locality (G33, G34, G69, G71) approx 50,000

StobhillHospital

MacKinnon House is a purpose built acute admission unit and was opened in April 2000 following the closure of WoodileeHospital. The unit is 6 miles from ParkheadHospital and 7 miles from the Larkfield Centre. The unit comprises 3 twenty-bedded locality wards (Broadford, Armadale and Struan Wards) and a 12 bedded IPCU (Portree Ward). There is an ECT Suite with dedicated sessional staff, a Life-Skills Department, a Mental Health Tribunal suite, Library and on-call facilities.

Eriskay House is a 15 bedded inpatient unit located directly opposite MacKinnon House on the Stobhill site. This houses addiction inpatient beds and day patient facilities for the North East sector.

The North Psychotherapy and Psychology Department is adjacent to MacKinnon House. On site are the Old Age Psychiatry Wards and Day Hospital, Addictions Psychiatry Offices, Liaison Psychiatry Offices, Addiction Inpatient Services, Inpatient Support Services and the Area Management Team/Clinical Director.

Stobhill Hospital Site

StobhillHospital comprises MacKinnon House with 3 adult acute admission wards and a 12 bed IPCU. Two old age wards, an Addiction unit (Eriskay House); an Adolescent Unit (Skye House); Psychotherapy; Psychology and Liaison Psychiatry departments are on site. There is an active Lifeskills Unit attached to MacKinnon House with Occupational Therapy and Physiotherapy/gym. ECT for north of the river is all done in a purpose built ECT suite. There is a medical library and on-call accommodation for SHOs. There is a suite for Mental Health Tribunal hearings

Medical Staffing – North Glasgow

Consultant Staffing

Dr D MonaghanGeneral Adult Psychiatry, Kirkintilloch Health & CareCentre

Dr A CoganGeneral Adult Psychiatry, Shawpark Resource Centre

Dr M KeenanGeneral Adult Psychiatry, Shawpark Resource Centre

Dr R WardGeneral Adult Psychiatry (part time), Springpark Resource Centre

Dr D BrownGeneral Adult Psychiatry, Springpark Resource Centre

(part time)

Dr R HosieGeneral Adult Psychiatry, Kirkintilloch Health & Care Centre

This PostGeneral Adult Psychiatry, Hydepark Business Centre

Dr D BrownLead Clinician, Old Age Psychiatry, Bridgeview Centre

Dr A FergieOld Age Psychiatry, Woodlands Centre

Dr S WylieAddictions Psychiatry, Eriskay House, StobhillHospital

Dr A CohenPsychotherapy, Stobhill Hospital (part-time)

Dr E OgstonPsychotherapy (part time)

Medical Staffing Early Intervention Service (as part of the medical staffing in each sector)

Dr A BlairEarly Intervention Psychosis Service, North East Glasgow

Dr K SowerbuttsEarly Intervention Psychosis Service, North West Glasgow

Dr S BrownEarly Intervention Psychosis Service, South Glasgow

* = SpR trainer

Non Consultant Career Grades

Dr P ForresterSpecialty Grade, General Adult Psychiatry, Shawpark Resource Centre

Dr KB IdrisSpecialty Grade Doctor, General Adult Psychiatry, Springpark Resource Centre

Dr F Duncan Specialty Grade Doctor, General Adult Psychiatry-CTT (part-time), Larkfield Resource Centre

Dr L GemmellSpecialty Grade Doctor, Old Age Psychiatry Woodlands Centre

Specialist Registrars are attached to SpR trainers as their need requires.

There are 11 SpR’s on the North Glasgow Training Scheme.

ParkheadHospital Site

ParkheadHospital opened in 1988and comprises 2 adult acute wards adjacent to the Anvil Centre. Occupational Therapy and Physiotherapy/gym are provided on site. There is a medical library and on-call accommodation for SHOs. The Mental Health Tribunal holds hearings in the Millan Suite at ParkheadHospital. IPCU facilities, Addiction beds and ECT are based at StobhillHospital. East Psychotherapy and Psychology are based at Carswell House. The plan is to relocate in-patients to the StobhillHospital site adjacent to MacKinnon House, opening in 2016.

Greater Glasgow Health Board’s “Modernising Mental Health Services” strategy is resulting in major investment in new and innovative mental health services, including early intervention and perinatal mental health services. A Perinatal Mental Health Service Mother & Baby Unit has opened in LeverndaleHospital to the south of the city. Consultants havebeen appointed to roll out the Early Intervention Service for Psychosis citywide. A Primary Care Mental Health Strategy has been established to improve the management of patients whose needs are best met within primary care rather than secondary care services.

Medical Staffing – East Glasgow

Consultant Staffing

Dr J AndersonGeneral Adult Psychiatry, Anvil Centre

Dr D J Brodie*Liaison Psychiatry

Dr R Brown*Old Age Psychiatry, Parkview Centre

Dr M CohenPsychotherapy, Carswell House

Dr M CooneyAddictions Service, ParkheadHospital

Dr D CulshawGeneral Adult Psychiatry, Arran Centre (part time)

Dr O Gallagher*General Adult Psychiatry, Arran Centre Inpatients & Clinical Director

This PostGeneral Adult Psychiatry, Auchinlea Resource Centre

Dr I MacKayHomeless Addiction Service

Dr D Mason*General Adult Psychiatry, Anvil Centre

Dr R McCafferyGeneral Adult Psychiatry, Anvil Centre and Clinical Tutor

Dr K McElroyGeneral Adult Psychiatry,Arran Centre

Dr S Reddy General Adult Psychiatry, Arran Centre

Dr A PhillipsonOld Age Psychiatry, Parkview Centre

Dr S ThomsonGeneral Adult Psychiatry, Auchinlea Resource Centre Undergraduate Tutor

Dr M Turner*General Adult Psychiatry, Auchinlea Resource Centre

Dr A Williams Psychotherapy, Homeless Service

* = SpR Trainer

Non-Consultant Staff

2 x Vacant PostSpecialty Grade Doctors

There are around 12 junior medical trainees on the East Glasgow Training Scheme.

There are 4 higher trainees.

Duties of the Post

The successful applicant will be expected to work with colleagues to provide a comprehensive service to patients with Early Intervention Psychosis within North East Glasgow. This would include follow-up of these patients for a minimum of 2 years after first diagnosis. North East Glasgow has mixed deprivation, with a mixture of deprived inner city areas and affluent suburbs. It is expected that all admissions would come to StobhillHospital as services are reconfigured.

The Early Intervention Team and the successful applicant would be based together at Hydepark Business Centre. They would be supported by Specialty Grade sessions, clinical psychology sessions, 1 Clinical Co-ordinator (for all Esteem services), 1 Support Staff, a medical secretary and 5 Community Psychiatric Nurses/Occupational Therapists, or equivalent. Mental Health Officers would be located within the individual Community Mental Health Teams. It is expected that the successful applicant would work closely with their Community Mental Health Team, Social Work and Voluntary Organisations to provide a

comprehensive service, including inpatient and outpatient treatment, working as part of a multidisciplinary team. They will participate in the on-call rota and cover for colleagues during absences in line with arrangements set out in national Terms & Conditions. The on-call rota covers the North East and Northwest sectors of Glasgow and full-time Consultants are on-call 1:60 rota. Domiciliary visits, court reports, Mental Health Act/Adults with Incapacity and liaison assessments will be undertaken as required. Duties also include continuing clinical responsibility for the patients in your charge, allowing for all proper delegation to/and training of staff.

It is expected that the successful applicant would be an Approved Medical Practitioner in terms of the Mental Health (Care & Treatment)(Scotland) Act 2003 by the time of appointment. The Early Intervention Service is a well-established model in Glasgow. It targets all new presentation of psychotic illness and provides continued input for the first 2 years. The aim is to provide maximum functional recovery during this period and improve longer-term outcomes. It is expected that the Esteem Service in North East Glasgow will work closely with carers and provide psychosocial interventions where appropriate.

The service model is based on early intervention philosophy and the Glasgow Integrated Care Pathway for Psychosis. The aims are to minimise the duration of untreated psychosis, minimise trauma, promote recovery and functional outcome and provide support to families. It is expected that there will be a capped 15:1 caseload and that members of staff provide an active occupational therapy programme and psychosocial interventions, including family work and cognitive behavioural therapy. It would be expected that Community Mental Health Staff would assertively follow-up patients in the community and also provide in-reach to inpatients visiting them at least weekly, even when boarding in other hospitals. The Esteem team services may be augmented by the Crisis Service, which provides intensive support in order to prevent admission and facilitate discharge. The consultant would be responsible for inpatients and working as part of a broader consultant team.

Patients would not be excluded on grounds of drug use, unless the psychotic symptoms were clearly due to acute intoxication with a drug. There would be discussions with the Perinatal Service to decide which service would most appropriately manage patients, but it would be expected that most patients admitted to the Perinatal Unit would be followed up by the Perinatal team for a year and then transferred directly back to the local CMHT.

The Service will provide a rapid assessment and it is expected that most patients will be assessed within 2 working days of receipt of referral. Referrals will usually be made to the local adult CMHT or adolescent team, who would co-ordinate the initial assessment. Wherever possible, assessments will be joint with the Locality Community Mental Health/Adolescent Team to provide continuity of care if the patient is not taken on by the Early Intervention Psychosis Service. If the Community Mental Health Team/Adolescent Team are unable to provide staff for the assessment within this period of time, the person will then be assessed by 2 members of the Early Intervention Psychosis Service. Responsibility would be with the local CMHT/Adolescent Team until it is agreed that the Early Intervention Team will take over the patient’s care. If the person is accepted for a period of assessment, it would be expected that the patient’s family will have been contacted by the Esteem Team within 5 working days of the initial assessment. Wherever possible, the key-worker undertaking the initial assessment will provide ongoing care so as to provide continuity. It would be expected that any expected patient will have a medical assessment within 5 working days of the initial assessment.

The service will involve patients in their care, provide information and choices, and deliver home-based care. These strategies are to empower the individual and minimise trauma. It is expected that the service will actively search for co-morbidity and provide a wide range of psychosocial interventions to promote recovery. The Early Intervention Psychosis Service will provide support and information to families, both individually and group sessions. It is expected that patients will be provided with a high level of input during recovery to allow work on the underlying vulnerability to psychosis. The team aims to effectively manage risk by

establishing a solid relationship with the patient and their family with the aim of avoiding admission and minimising the use of the Mental Health (Care & Treatment)(Scotland) Act 2003.

It is expected that the medical component of care should be the responsibility of the Consultant Psychiatrist and this should be reflected within the ICP review process. The review process will also involve the families wherever possible. Sharing of information between the team, the young person, their family and their General Practitioner should be given a high priority.

The service has a strong emphasis on multidisciplinary working. All care will be based on multidisciplinary formulation with expert input from medical, psychological, occupational therapy and nursing staff shared with the patient and his family and determining the treatment plan. It is expected that the team will be able to provide social and psychological

interventions, particularly to deal with problems caused by social isolation, trauma, anxiety and the misuse of drugs and alcohol.

The Early Intervention Psychosis Service in North East Glasgow is also expected to influence practice outwith the service. This would be demonstrated by offering early intervention awareness sessions to Primary Care, Community Mental Health, Adolescent Mental Health Service and the Inpatient Services. It is also expected that the service will link with Social Work Services when these are not integral to the Locality Community Mental Health Teams. Strong links will also have to be developed with Housing, Education and Employment Agencies, as well as other youth-orientated services and organisations.

Teaching/Administration

The post holder will undertake the administrative duties associated with the care of patients and the proper function of the clinical team including appraisal and non-clinical supervision of medical staff and clinical supervision of non-medical staff. He or she will also be expected to participate in the broader aspect of administration and management within the North East Glasgow Division of Psychiatry.

It is expected that the successful candidate will take part in Job Planning, Appraisal, Peer Review and Continuing Professional Development. Participation in audit or research is encouraged. The post holder will be actively involved in the teaching of undergraduate medical students. It is anticipated, in recognition of this, that GlasgowUniversity will grant the status of Honorary Clinical Senior Lecturer in Psychological Medicine. In addition the post holder will be expected to participate in the postgraduate teaching of medical staff and staff of other disciplines.