CONSULTANT in Child and Adolescent Psychiatry

CONSULTANT in child and adolescent psychiatry

home intensive treatment teAM & SKYE HOUSE ADOLESCENT PSYCHAITRY

INFORMATION PACK

REF: 35627D

cLOSING DATE: nOON on 23RD January 2015

As you may be aware, the new SouthGlasgowUniversityHospital and new RoyalHospital for Sick Children are due to open on the current Southern site early in 2015.

With this in mind, please note that positions based within the Victoria Infirmary, Mansionhouse Unit, the Western Infirmary and the current RoyalHospital for Sick Children at Yorkhill will change location and move to the new hospitals.

Gartnavel GeneralHospital and Glasgow Royal Infirmary will also have some services affected by moves to the new Hospitals.

These changes mean your base may change after joining us and you will be informed as soon as possible prior to any change of base.

SUMMARY INFORMATION RELATING TO THIS POSITION

Post: CONSULTANT in child and adolescent psychiatry

Base:home intensive treatment team & SKYE HOUSE ADOLESCENT INPATIENT UNIT

This post offers the chance to participate in an exciting new development.

The recently developed nurse led home based intensive treatment team has been running successfully for 2 years and it has been decided to expand this into a full Tier 4 provision. The Consultant Psychiatrist will be responsible for the most severe and complex patients within the home intensive treatment team and will have access to the regional adolescent inpatient unit to which they will provide inpatient care.

Experience in Paediatrics, General Practice or a Medical Specialty would be a bonus. The Consultant Psychiatrist’s primary responsibilities will be to take RMO responsibility for adolescents with severe and complex psychiatric illnesses including low weight eating disorders, psychosis requiring intensive input and potential inpatient care regarding medication management and co-morbid conditions. NHS Greater Glasgow & Clyde are developing a junior MARSIPAN care pathway for young people with low weight eating disorders in partnership with the New Children’s Hospital in Glasgow and relationships with staff in the hospital will be important to allow the delivery of best care.

Applicants must have full GMC Registration with a licence to practise and MRCPsych or equivalent. Experience of having worked in tier 4 is essential. Those trained in the UK should have evidence of higher specialist training leading to CCT in Child & Adolescent Psychiatry or eligibility for specialist registration (CESR) or be within 6 months of confirmed entry from date of Interview.

There is a large and supportive body of Child and Adolescent Psychiatrists in this Health Board with opportunities to engage in Research, Teaching, CPD and the pursuit of special interests.

These services are situated in Glasgow which is a vibrant multicultural city, providing a range of Cultural, Sporting and Outdoor activities. There is easy access to the beautiful Scottish Highlands and Islands and a major international Airport giving direct access to a variety of destinations.

Applications are welcome from anyone wishing to job share or work part-time.

CONSULTANT CHILD AND ADOLESCENT PSYCHIATRIST

INTENSIVE TREATMENT SERVICE &SKYE HOUSE WEST OF SCOTLAND INPATIENT UNIT

STOBHILLHOSPITAL

NHS GREATER GLASGOW AND CLYDE

GENERAL INFORMATION FOR CANDIDATES

1. This information package has been compiled to provide prospective candidates with details of the post and background information about NHS Greater Glasgow and Clyde Specialist Children’s Services.

1. The contents of this package are as follows:-

1. Job Description
2. Terms and Conditions of Service
3. Further Information

1.JOB TITLE

Consultant Child and Adolescent Psychiatrist

2.LOCATION

Home Intensive Treatment Service & Skye House West Of Scotland Adolescent Inpatient Unit, StobhillHospital

1. HOURS OF DUTY

10 PAs (40 hours per week + out of hours duties)

4.GENERAL BACKGROUND

This is a newly configured post based at Skye House Adolescent Psychiatry Inpatient Unit. It is a Tier 4 Post designed to work with young people with severe and complex disorders in the community but with availability of beds when the clinical needs require admission.

This service is in the process of exciting developments following a review of Child and Adolescent Psychiatry services in Glasgow and Clyde. This has led to the development of a number of initiatives including a nurse-led Home Based Intensive Treatment Team in order to help patients receive their treatment in the community and to shorten length of stay if admitted to hospital.

This newly configured Consultant Psychiatrist post is designed to give continuity of care to the most severely unwell and complex cases so that the psychiatrist will have access to intensive community treatment and inpatient beds when needed. Most of the patients requiring intensive treatment remain the responsibility of the Tier 3 community team – however it is expected that a small number of those with the most severe and complex difficulties will be taken over by the new post holder who will take on RMO responsibility for them at a Tier 4 level. This follows discussions with the community Tier 3 consultant and team. It is expected that the Consultant Psychiatrist in this post will take responsibility for patients with medical complications arising from severe low weight eating disorders, with a mix of other young people with difficult to manage psychosis with possible co-morbidities and young people with complex psychiatric presentations and social vulnerabilities. As the Psychiatric input to the Intensive Treatment Team is newly funded the post holder will have the exciting task of developing this role and integrating it with inpatient care.

The current Home Intensive Treatment Team consists of an experienced team of psychiatric nurses who provide intensive support to children and young people in NHS Greater Glasgow & Clyde with psychiatric disorders. In addition to this post, a Consultant Clinical Psychologist will also be recruited to provide formulation and psychological crisis intervention skills to children and young people who require these skills.

The well-integrated multi-disciplinary inpatient team works collaboratively and flexibly to achieve a very high standard of care and regularly meets with Intensive Treatment Team staff. The overall philosophy of care is to provide for the assessment, diagnosis and treatment of young people who have severe and complex mental health difficulties using evidence-based practice in the context of the young people’s personal development, family life and continuing education with the aim of preventing chronic illness whenever possible. The clinicians aim to provide the highest standard of care possible by keeping up to date with developments within the field of child and adolescent psychiatry. Although the inpatient unit is a Regional Specialist Tertiary referral service - this post will provide care for Greater Glasgow and Clyde patients only with full access to beds and the multi-disciplinary team if required.

The staff aim to provide high quality mental health care for adolescents, meeting the requirements outlined in the following documents:-

1. The Patient’s Charter
2. The Children in Hospital Charter
3. The Children ( Scotland ) Act 1995
4. The Age of Legal Capacity (Scotland) Act 1991
5. The Mental Health (Care and Treatment) (Scotland) Act 2003
6. Other legislation or policy documents as necessary.

The inpatient unit aims to be responsive to the needs of young people presenting with a wide range of mental health disorders, and operates using the admission criteria listed below.

Admission Criteria

Severe psychiatric disorders such as psychoses, major affective disorders, severe eating disorders, complex psychosomatic disorders, and neuropsychiatric disorders, etc

Where the Community or other Tier 3 service is struggling with a complex, diagnostic problem, and IP assessment would seem appropriate

Supporting the admission of other cases as deemed appropriate especially where there is a severe risk of self-harm and/or harm to others secondary to mental health disorders

The following would make admission unlikely

Young people whose sole or major difficulty is a conduct disorder. There is considerable clinical evidence that the needs of such young people are not best met within the setting of a unit whose primary function is to care for young people suffering from mental illness.

The unit is also unable routinely to meet the needs of young people with moderate to severe learning disabilities although these may be considered on a case by case basis.

The unit does not provide specific treatment for young people whose main problem is drug or alcohol abuse. The unit does however provide care for young people with a history of substance misuse and concurrent psychiatric disorder e.g. drug misuse associated with a psychotic illness.

Young people who require an admission to a Forensic Adolescent Unit. The unit is an open unit (i.e. non-secure setting) and as such, cannot cater for seriously ill adolescents who continue to pose a major risk to adolescents and/or staff.

The team are able to offer a wide range of treatments including various group and individual therapies and family therapy. The Unit has excellent links with paediatric services including neurology and is able to access a full range of investigative facilities. There are also close links with the community child & adolescent mental health teams and the University Department of Child and Adolescent Psychiatry. There is an active academic programme and good academic links with other centres.

1. GENERAL DESCRIPTION OF THE INPATIENT TEAM

The multi-disciplinary team is consultant led and comprises 2.5 wte consultant psychiatrists, Dr Anne-Marie Discombe, Dr Jane Fuller and this post (0.5), with Alex Fleming as Service Manager and Jacqueline Hardie as Senior Charge Nurse. The Unit staffing also includes middle grade doctors and the disciplines of nursing, occupational therapy, clinical psychology, dietetics, speech and language therapy, family therapy and sessional input from other professionals. The inpatient unit is approved for placement for doctors in training: ST4-6s in Child and Adolescent Psychiatry and CT1-3 in Psychiatry. The post holder would be welcome to apply to the West of Scotland Deanery for approval as an educational supervisor with time allocated in the job plan to do this. There is a well-staffed school providing comprehensive educational opportunities and liaison with community schools. A part time social worker completes the team.

Medical Staff in the Adolescent Unit

Consultant Psychiatrist 1 wte

Consultant Psychiatrist1 wte

Consultant Psychiatrist0.5 wte (current vacancy)

Associate Specialist0.6 wte

Speciality Doctor0.55 wte

Speciality Doctor0.6wte

Speciality Doctor1 wte

Usually one or two ST 4-6 CAMHS trainees will also be placed in the Unit and attached to the Consultant Psychiatrists in the Unit who are Educational Supervisors.

Allocation of SAS doctor time will be agreed with all medical staff in Skye House on appointment to this post.

CAMHS Home based Intensive Treatment Team (HITT)

The HITT Service provides a rapid response (within 48 hours) to children and young people who have acute mental health disorders requiring intensive support in the community. Where clinically appropriate the service is offered as an alternative to hospital admission, but also to facilitate early discharge and support back into the community where an acute admission has occurred.

By providing treatment in the home the service aims to establish a positive culture and approach by supporting individuals’ coping strategies in a less restrictive environment.

Referral Criteria:

• Aged 0-17 inclusive
• Young people residing within NHS Greater Glasgow and Clyde catchment area
• Young people living at home, NHS inpatients or living in Specialist Residential Units
• Suffering from moderate to severe mental health problem
• Currently know to locality\Tier 3 teams
• Requiring Intensive Home Treatment

The HITT Service’s current staffing is managed by the Lead Nurse for CAMHS, Lauren MacFarlane, and comprises community mental health nurses and clinical support.

6.NHSGGC CAMHS

NHS Greater Glasgow and Clyde was created in 2006 by the amalgamation of the whole of NHS Greater Glasgow (GG) and part of NHS Argyll and Clyde. As a result of significant investment and expansion a number of health board-wide services were developed in response to identified needs of several groups of children and young people who were not well served by the existing arrangements. These services were focused on children and young people with mental health problems –

1. who also had a learning disability (LD-CAMHS);

1. who were also involved in serious offending (Forensic or F-CAMHS);

1. who were also looked after and accommodated (LAACMH team);

1. who required intensive home treatment.

1. who required support from the Self Harm Team.

Consultant Psychiatrists within NHSGGC CAMHS

Community Teams:

No of Consultants (headcount) / Location / Total WTE
3 / East Glasgow CHP (Bridgeton) / 2.3
3 / South Glasgow CHP (Gorbals) / 2.1
2 / North Glasgow CHP (Gorbals) / 1.3
2 / West Glasgow CHP (West Centre) / 1.4
2 / Renfrewshire CHCP / 1.44
1 / East Renfrewshire CHCP / 1
1 / Inverclyde CHP / 1
1 / West Dunbartonshire CHP / 0.8

City/Board/Area/Country Wide Teams:

No of Consultants (headcount) / Locations / Total WTE
1 / LD-CAMHS (FergusonSmithBuilding, RHSC) / 1
1 / LAAC CAMHS (FergusonSmithBuilding,RHSC) / 0.5
1 / Forensic CAMHS (FergusonSmithBuilding, RHSC) / 0.5
2 / Paediatric Liaison Team (RHSC) / 1.4
2 / Child Inpatient Team (Caledonia House, RHSC) / 1.35
3 / Adolescent Inpatient Team (Skye House, Stobhill) / 2.5
2 / Academic Team (Caledonia House, RHSC)

Services within NHS GGC CAMHS:

Service / Location
East Glasgow CAMHS / Kerr St, Bridgeton
West Glasgow CAMHS / Knightswood Clinic, Knightswood Road
South Glasgow / Southbank and Twomax, Gorbals
North Glasgow CAMHS / Possilpark Health Centre
Renfrewshire CAMHS / Aranthrue Centre, Renfrew
East Renfrewshire CAMHS / Barrhead Health Centre, Barrhead
Inverclyde CAMHS / Larkfield Centre, Greenock
West Dunbartonshire CAMHS / Acorn Centre, Vale of LevenHospital
Tier 4 CAMHS / FergusonSmithBuilding, RHSC
Paediatric Liaison Team / Ward 5b, RHSC
National Children’s Psychiatric Unit / Caledonia House, RHSC
Scottish Centre for Autism / Caledonia House, RHSC
West of Scotland Regional Adolescent Inpatient Unit / Skye House, StobhillHospital
University of Glasgow Child and
Adolescent Psychiatry Team / Caledonia House, RHSC
Eating Disorder Service (CONNECT ED) / Templeton Business Centre, Bridgeton
Multi-Dimensional Treatment Foster Care / Templeton Business Centre, Bridgeton
HITT Intensive Treatment Service / SkyeHouseStobhillHospital

7.LINE MANAGEMENT

Specialist Children’s Services (SCS) are managed by the North East Glasgow Sector of Glasgow CHP, whose current Director is Mr Mark Feinmann. The Head of Specialist Children’s Services (SCS) (currently Mr Stephen McLeod) has the lead in planning, developing and managing CAMHS services across NHSGGC. He is supported by service managers including Mr Alex Fleming for the Home Intensive Treatment Team and Skye House.

Management accountability is via the Service Manager through Lead Consultants to the Clinical Director for CAMHS.

The Clinical Director for CAMHS in NHSGGC is Julie Metcalfe. She is supported by one Lead Consultant Child and Adolescent Psychiatrist at present with a vacant Lead Consultant position to be filled soon. One of the two Lead Consultants will provide support and management in relation to job planning to the post holder. Dr Michael Smith is the Lead Associate Medical Director for Mental Health in NHS Greater Glasgow and Clyde.

Clinical governance arrangements are channelled, via a clinical governance executive group, to the NHSGGC CAMHS Clinical Director on behalf of the Director of North East Glasgow CHP sector.

The post holder will be a member of the Greater Glasgow and Clyde Division of Child and Adolescent Psychiatry which offers professional advice to managers across the organisation.

Annual leave and study leave will be covered by Consultant colleagues in CAMHS Tier 3 and Tier 4.

Organisational Chart

8. Clinical duties of the Post

The post is full-time 10 Programmed Activities per week (It is planned that the post will be configured as 9 PAs of Direct Clinical care and 1PA for Supporting Professional Activities) based at Skye House Adolescent Unit. Any additional SPA time would have to be negotiated for specific pieces of work or training.

This post carries clinical responsibility (RMO) for the delivery of intensive community and in-patient services to adolescents and their families referred by Tier 3 Teams from across Greater Glasgow and Clyde. This includes liaising with referrers, prioritising admissions, leading the care of patients and working with the Tier 4 teams including deciding with community colleagues which patients remain as Tier 3 and which require to have RMO transfer to Tier 4. There will be liaison with other agencies involved with the mental health needs of patients. The Consultant Psychiatrist will provide medical leadership within the teams with regard to delivering the service required and using the teams’ resources in an effective and efficient manner. The new Consultant will participate in the Unit’s Senior Staff, Operational Management and any strategy groups that address the administrative running and forward planning of the Service.

9.General Consultant Duties regarding the entire post