Cumbria Partnership NHS Foundation Trust

Consultant in General Adult Psychiatry

Job Description

General Adult Psychiatry

South Cumbria

10 PAs: Full Time/Part Time/Job Shares will be considered

Professionally Accountable to: Medical Director

Operationally Accountable to: Clinical Director/General Manager

Professionally Accountable to: Medical Director

Operationally Accountable to: Clinical Director/General Manager

Contents

1.  Cumbria Partnership 3

2.  Cumbria Roles & Support to Deliver them 4

3.  Clinical Roles 4

4.  Job Plans 6

5.  The Service: General Adult Psychiatry North Cumbria 8

6.  CPD and Research 10

7.  Interview Arrangements and how to apply 10

8.  General Information 11


1. The Trust

Cumbria Partnership NHS Foundation Trust (CPFT) operates in a county that includes the Lake District National Park with opportunities for living in beautiful places and accessing a wide range of outdoor pursuits. Carlisle in the north east and Barrow in the south west are the biggest centres of population but there are attractive market towns dotted across the county.

State and private schools have excellent reputations with a number of secondary and primary schools having outstanding Ofsted reports. Housing is affordable and high quality in many areas.

Although Cumbria is primarily rural it is well connected to the rest of Britain and hence the world. Some indicative journey times include:

Carlisle to Newcastle 75 minutes by car

Carlisle to Edinburgh 90 minutes by train

Kendal to Manchester 90 minutes by train

Kendal to London 3 hours by train

The Trust uses technology to reduce the need to travel around the county and all consultants will have their own desk PC, tablets and smartphones.

CPFT has been a Foundation Trust since 2007 and since 2010 has been responsible for community and mental health services.

In summer 2013 Claire Molloy began as our new CEO and has accelerated the process of designing high quality sustainable services for the dispersed population of Cumbria. We are working increasingly closely with colleagues in social care and clinical commissioning both of which operate across the whole county. As part of this process, a vision for mental health services is being developed with input from clinicians, patients, carers and others. A draft is supplied in the list of additional documents.

A key theme of this redesign is enabling more effective clinical leadership by the creation of clinical divisions (Appendix 3 for draft organisational structure). We have very skilled leaders of psychosis and non-psychosis and older people’s pathways – we now need to better enable the delivery of high quality pathways across the Trust. Existing and new consultant psychiatrists have key leadership roles in this improvement journey.

Corresponding and integrated redesign is taking place in the other divisions with opportunities for increased roles for consultant psychiatrists in primary care and liaison.

The Trust has close links to the medical schools in Newcastle (North Cumbria) and Lancaster (South Cumbria) and it is expected that consultants contribute to undergraduate and post graduate teaching and learning. Honorary lecturer positions are available for interested candidates.

2. Support for Consultants.

Consultant psychiatrists in CPFT are supported to take on roles that support excellent services and their own development. There is an active mentoring system for new consultants and a highly regarded action learning set that enables new consultants to develop the skills they need to thrive.

Appraisal and revalidation for all CPFT doctors is managed by the Medical Director and Responsible Officer with support from a dedicated team. We have a skilled team of appraisers and new consultants working to become (or continue as) appraisers will be supported to do so.

All consultants have smartphones, iPads and a desk PC in their own office. Each has access to a medical secretary.

3. Clinical Roles

The variety of clinical roles that may be taken on by consultant psychiatrists in CPFT include

·  Community roles

·  Inpatient roles

·  Leadership

·  Educational and academic roles

A - Community Roles

Role description / Tasks
New out-patients or home visits, including meetings with relatives and carers
Follow up out-patients or home visits
Team meetings
Multidisciplinary patient reviews
Clinical advice to team members
Liaison with colleagues
Mental health and capacity legislation / Assessment, diagnosis and formulation of management plan
Shared decision-making with users and carers
On-going review of formulation and management plans
Shared decision-making with patients and carers
Communication about patients and carers, sharing organisation policies and objectives
Care programme approach (CPA) reviews, Multi-agency Public Protection Arrangement (MAPPA) meetings, risk reviews
Regular or ad hoc supervision on clinical matters
Discussion about patient care with primary care, secondary care and colleagues in other psychiatric teams
Meeting the requirements of emergency work, community treatment orders, assessments of capacity

B - Inpatient Roles

Role description / Tasks
Direct clinical work with patients and carers
Multidisciplinary reviews
Clinical team meetings
Mental health and capacity legislation
Clinical advice to team members
Liaison with colleagues and other services / Assessment, diagnosis and treatment
Ensuring physical health is considered alongside psychological and social issues. Shared decision making with patients and carers
Patient assessments, CPA review, MAPPA meetings, risk reviews
Decision making meetings. Reviewing daily workload
Assessments, report writing, attendance at mental health tribunals and managers hearings, assessments of capacity
Regular or ad hoc supervision on clinical matters
Speaking with other professionals involved in patient care – primary care, CMHTs, general hospitals.

C - Leadership Roles

Role description / Tasks
Leadership role
Lead clinical roles
Lead consultant / Implementing and reviewing standards, innovation in service delivery, clinical governance, patient safety, modelling high-quality patient care, supporting colleagues, building relationships with GPs and other external organisations
Provide leadership role for specific and defined areas
of development or practice
Provide leadership and often line management for consultants and other medical staff within the service, often lead for quality within a directorate.

D - Education and academic roles

Role description / Tasks
Supervision of trainees
Meeting requirements for revalidation
Training medical students
Education
Research / Each trainee requires 1 hour of trainee-centred educational supervision per week
Additional supervision will be required for clinical work
Revalidation activities including continuing professional development and quality improvement activities and reflection on serious incidents.
One to one teaching, lectures, examining and skills-based workshops
Lectures, small group teaching, skills workshops
Clinical and service research, peer reviewing of papers.
Including department programme, trainee doctor programme, medical student programmes, college tutor, deanery roles

Opportunities for part-time or other flexible models of employment are available via discussion and might include annualised job plans.

Job plans are for 10 PAs but additional responsibility payments are available for specific roles and additional payment possible for some out of hours work and agreed hours beyond 10 PAs.

4. Job Planning

The nature of such roles and more specific tasks is determined by job planning. The full time week is split 7.5 direct patient care and 2.5 for supporting professional activities. For this post the initial vacancy requires inpatient and community commitments.

Building your job plan

4.1. Agreeing your job plan

The successful candidate will agree their job plan with consultant colleagues, Clinical Director and manager. The job plan will be reviewed at least annually to ensure flexibility and to avoid burnout. The post holder will be managed by and accountable to the Clinical Director and will work closely with the broader MDT.

4.2. Indicative timetables

Here is an example timetable

Inpatient/Community

MON / TUE / WED / THU / FRI
AM / Clinical- inpatient ward reviews / Clinical- inpatient ward reviews / Clinical – Outpatient clinic / Clinical – Admin/
Meetings/
Special interest / SPA – Med Ed teaching
PM / Clinical –inpatient ward reviews/
Admin / SPA – teaching/ research / Clinical – Outpatient clinic /admin / Clinical- inpatient ward reviews/ Admin / SPA/ TIL

The combined job plans of the whole consultant team need to meet the needs of the service. Existing consultants are committed to flexibility around who does what so that each member of the consultant team is enabled to have a “do-able” job with the expectation of being able to develop particular clinical interests.

Key components of the service that need to be supported by consultant job plans include:

ü  Inpatient

ü  Liaison

ü  Eating-disorders

ü  CRHT

ü  Specialist community mental health: Emerging Psychosis, as well as sessions dealing with other psychosis, non-psychosis and others as identified by the consultant team e.g. follow up of special interests.

Each consultant will have 2.5 SPA that can be used to support CPD, other professional activities, project work or other specific tasks agreed with clinical director. There will be an option to develop medical education or other areas of specialist interest if the applicant was keen to pursue these.

5. The Service – General Adult Psychiatry (South)

The current post is in General Adult Psychiatry working into the Community Health Team, inpatient team and providing supervision to CRHT, South Lakes, with other options such as specialist teams by negotiation and through job planning. This is a vacancy that has arisen from retirement with the previous post older working across inpatients and CMHT in South Lakes. An interest in working with the medical education team to extend the building of our relationships with Lancaster medical school and research within the trust would be welcomed.

General Adult Psychiatry Clinical work across South Cumbria is divided in teams by a combination of sectorisation and division by function, for example inpatient units, CRHT and CMHT have dedicated consultant time and staff grades in addition to psychiatry trainees, GP trainees or foundation doctors. CMHT input by consultants has been configured to ensure that all areas have equitable and continuous service and cover by two consultants.

General Adult Consultants are part of the clinical team providing services across South Cumbria with footprints in the South Lakes and Furness localities.

Description of Locality

South Lakes Population 103,500

Community Mental Health Services South Lakes

First Step/Primary Care MH Services

CMHT Kendal

This is a multidisciplinary team serving local catchment GP surgeries. The staff have been organised by -

Psychosis, (including AOT and EIP work)

Non-Psychosis (including personality disorder)

These teams are presently organised by a combination of PBR cluster and locality (GP alignment). The integrated community mental health team consists of nurses, social workers, psychology input and input from Occupational Therapy and support staff. Treatment is delivered according to cluster based treatment pathways: psychosis and non-psychosis. Consultants work across these pathways.

Work within the team includes assessment, short term intervention and recovery in close conjunction with care co-ordinators. Patients are referred into the service via single point of access. The post-holders will be expected to provide direct care to patients and to play a major role in supervision of clinical work by other team members. Where clinics are arranged the usual arrangement would be for new patients to be allocated 1 hour, follow-up appointments of 30 minutes, with allotted time for administration. In CMHT medical colleagues are Dr A Simpson and Dr N Barton. The trust has agreed a policy on roles and responsibilities of consultant psychiatrists.

Referrals into the South Lakes team average 12 per week and medical staff support CMHT throughout the pathways.

CRHT (Crisis Resolution/Home Treatment)

The South Lakes team receive referrals averaging 9 per week.

Out of hours the CRHT service is based in Barrow. All admissions involve CRHT as they gate-keep

admissions to ensure all community options have been considered. Most of the medical support to CRHT is via Dr Thomas, the post holder would provide cover in her absence.

Inpatients

Kentmere ward in Westmorland General Hospital has 10 General Adult beds. The admission rate is between 1-2 per week with a recent average length of stay of 51 days . The nursing team is supported by occupational therapy and CRHT. In addition there are 2 beds for planned alcohol detox via Unity which Dr Thomas manages.

Specialist addiction services in Cumbria are provided by Unity (part of Greater Manchester West FT)

Medical Education

Applicants who are suitably experienced to further the work of the Learning Network and research within the trust would be particularly welcomed.

On Call

There is currently a review of on call work so there may be significant changes in the future. At present the south out of hours rota in 1 in 8.8 which attracts 0.5 PA and 0.5PA time in lieu.

PAs

Inpatient/Crisis 3.0

CMHT 3.5

Medical Education 1.0

SPA 2.5

On call 0.5

Total 10.5

The exact details of the clinical responsibilities of each post will be identified in job planning with the successful candidate. Job planning is a team process in the Directorate which allows individual consultants to develop their roles year by year.

South Cumbria Medical working age psychiatry workforce

Consultants

Dr Avice Simpson acting CD/CMHT Kendal/CMHT Barrow

Current Vacancy CMHT/Inpatient Kentmere/CRHT

Dr Miriam Naheed Inpatient Dova/Perinatal/Eating disorders

Dr Sivaram Appavoo In patient Dova/CRHT

Locum CMHT Barrow

SAS Doctors

Dr Rajini Thomas Associate Specialist Inpatient Kentmere/CRHT South Lakes

Dr Nischy Umesh Inpatient Dova

Dr Nicola Barton CMHT Kendal

Junior Doctors across South Cumbria working age:

ST 4-6 x 2 approved posts

CT 1-3 x 1 approved post

GPST1-3 x 2 approved posts

FY2 x1 and FY1 x 1

6. CPD and Research

Audit

CPFT Clinical Audit Team provides training to register clinical audits and provide advice and support you undertaking your audit. The team ensure that audit outcomes are shared not just within the Trust, but on a regional and national basis as well

Research

CPFT has an exceptional Research and Development team who are involved in a number of research and evidence-based working projects.Currently, the EIP team are becoming involved with a further study examining the implementation of REACT (A carers education study run from the University of Lancaster). The team strongly encourage applicationsfrom external researchers to conduct studies here. They are currently part of the following alliances and networks:

4  The North West Mental Health Research and Development Alliance