The Mental Health Crisis Assessment Service (MHCAS) is an innovative Crisis hub model which provides a mental health alternative to Emergency Department care for people in mental health crisis. The service has an ethos of improving both patient experience and outcomes for those people requiring an emergency assessment, the service was recognised and received the award for Excellence in Mental Health at the UK NHS Parliamentary awards in 2022. The service currently covers emergency mental health care at University College London, The Royal Free and The Whittington hospitals.

The service is undergoing an exciting development, with a purpose-built 'state of the art' Mental Health Crisis Hub due for completion in late 2023, at the Highgate Mental Health Centre. The Hub will then work in tandem with the emergency departments proving timely excellent emergency care.

All Clinical Specialists will be based in the one of the three Emergency departments during this time, carrying out psycho-social assessments in the Emergency Department and providing support to the medical wards out of hours.The plan, once the MHCAS hub opens in late 2023, will see the Clinical Specialists having the opportunity to work between the emergency department and the MHCAS hub. This provides the opportunity for the clinical specialist to gain extensive experience in working within an alternative mental health crisis setting, alongside the Emergency Department and offer variety within the role.

Main duties of the job

We are looking for skilled and dynamic Clinical Specialists with a passion for delivering outstanding patient care which, considers least restrictive options. You will be required to complete psychosocial assessments and develop safe and effective collaborative plans with service users. The service acknowledges that we often see people at their most vulnerable and as such it is essential that we provide, compassionate and trauma informed care. The service is dynamic and fast paced and the role therefore requires stamina, resilience and the ability to work in a joined-up way with Trust services as well as acute hospital colleagues.

Successful candidates will be supported through monthly supervision, yearly appraisal and facilitated monthly reflective practice.

Camden and Islington NHS Trust and are fully committed to the development of our Nursing workforce and have recently appointed a mental health nurse into an Approved Clinician post.

There are significant professional development opportunities, within the Trust through, non-medical prescribing course as well as the AMHP course.

The role covers a 24/7 service and therefore, weekend and nights working is a requirement of the role.

About us

At Camden and Islington NHS foundation trust our staff and service users have worked closely to create a set of values that make sure people who use our services get the best possible chance of a rapid recovery.

We have 3 key priorities which are:

• Early and Effective Intervention
• Helping People to Live Well
• Research and Innovation

The cultural pillars that help us achieve our key priorities are:

• We value each other
• We are empowered
• We keep things simple
• We are connected

By coming to work at Camden and Islington NHS Foundation Trust you will be joining a Trust with a national reputation for research, where services recognise that research underpins its commitment to providing high quality and innovative clinical care.

As an applicant for this role, you are urged to demonstrate within your supporting statement a combination of evidence that reflects your competence to meet the job specification and provide examples of how C& I Cultural pillars are an integral part of the way you have and will continue to deliver service.

The nature of liaison can be challenging, however is extremely rewarding as we are often the first point of contact for those in a mental health crisis, and the interventions and decisions we make can have a profound impact upon someone's life.

Job description

Job responsibilities

Clinical/Practice

The post-holder will:

Have theoretical knowledge of mental health liaison emergency and ward-based work deploying a wide range of theoretical approaches and utilise a wide variety of clinical skills appropriate to the needs of individual patients and the clinical setting in which they are required to be.

Be accountable and take direct responsible for carrying out specialist assessments including risk assessments unsupervised. Develop, implement, evaluate and document specialist care.

Undertake PMVA techniques to prevent and manage escalation in terms of patient harm to self and others.

Work closely with the NCL wide crisis services and maintain good working practices with all other CRTs as a means of ensuring least restrictive practice and outcomes.

Make autonomous decisions with regard to the admission and discharge of patients based on an analysis of complex presenting problems, and judgement about available options within agreed protocols. Direct and guide junior doctors on rotation with the service (including locums).

Provide a consultation-liaison and assessment service to clinicians and clinical teams within the general hospital. This will include giving specialist advice on a range of care, treatment and patient management.

Identify and be responsive to the diverse cultural social and spiritual needs of all.

Demonstrate a high standard of record keeping and documentation with adherence to acute general hospitals (RFH/UCLH/Whittington) and the Camden and Islington NHS Foundation Trust and local MHLT policies, and an understanding of professional guidelines and application of confidentiality.

Work with colleagues to develop and promote the services philosophy/framework of care delivery and strategic objectives, taking responsibility for specific areas of policy and delivery.

Work with colleagues to develop clinical expertise and high standards of nursing practice, as defined by the Nursing & Midwifery Code (NMC) of Professional Conduct (2015), and deliver care that is evidence-based, reflecting current best practice and research.

Participate in structured clinical supervision/appraisals in accordance with the Trusts policies and procedures. Be responsible for the formal supervision and appraisal of junior staff. You will also be responsible for the informal supervision of non-mental health nurses and others, including doctors and security staff, who are working with patients with mental health problems.

Demonstrate clinical excellence and high standards of nursing practice to other staff.

Demonstrate sound understanding of the legal and ethical issues in caring for the mentally ill. In particular, demonstrating sound understanding of the Mental Health Act (1983), and its use in a non-mental health setting e.g. a general hospital.

Report serious and untoward incidents within the department in accordance with the Trusts policies and procedures.

Post holder will co-ordinate shifts on a regular basis.

Managerial
The post-holder will: -

At the direction and in the absence of the Senior Nursing staff, take responsibility for the management of coordination of all activity within the clinical area or equivalent domain and for the management of the team, to the agreed local and professional standards. This includes taking responsibility for agreed clinical, and managerial projects associated with the provision of the Mental Health Crisis/Emergency Assessment Service and planning, implementing, reviewing and revising these projects as necessary.

Supervise, monitor and appraise the performance of registered and non-registered mental health staff below Band 6.

Ensure the promotion of the health and safety, wellbeing and interests of the patients, staff and all visitors who come into contact with the team and its service environments.

At all times follow the Code of Professional Conduct NMC (2015) and ensure that all staff within their sphere of responsibility also follow the code as laid down.

Assist with budget control by being aware of principle constraints in the service and have due regard of the budget within the service.

Act as change agent to promote innovation and high standards of practice.

Education, Training and Research and Development

Demonstrate a commitment to developing research skills.

Regularly undertake audit/research into patient/service-related areas and contribute to the application and evaluation of current research findings.

Identify areas of study/research/QI in the service, develop proposals and seek advice on funding to support such activities in collaboration with the Senior Nurse.

Develop methods at service level to monitor standards of care with the clinical audit department, (quality assurance/research).

Under the guidance of the Senior Liaison nursing staff, identify own professional development needs and demonstrate achievements against personal development plans.

Develop and participate in teaching/assessment programmes and learning resources for staff, students, patients, relatives/carers and security guards. To include allied agencies where practicable.

Facilitate a learning environment conducive to the acquisition of further knowledge and skills, act as a mentor/preceptor where appropriate.

Liaise with the associated universities and local L& D departments in all matters concerning nurse education.

Communication
The post-holder will: -

Demonstrate the ability to receive and give complex clinical details clearly, with patients, carers and colleagues and will negotiate and problem solve.

Demonstrate the ability to communicate clearly and sensitively in situations that are contentious and/or hostile.

Demonstrate a high level of interpersonal skills, self-awareness and empathy in all communications.

Negotiate and problem-solve in contentious and/or antagonistic situations where agreement is required or an ability to communicate clear decisions and rationale when agreement cannot be reached e.g. in situations where it may be necessary to use the Mental Health Act.

Accurately and comprehensively document completed assessments, including risk assessments and risk management plans along with outcomes of assessments.

Record required data correctly and contemporaneously within the current duty.

Demonstrate the ability to develop and maintain good working relationships with colleagues within the Mental Health Crisis Assessment Service, the Camden and Islington NHS Foundation Trust and the Whittington Hospital, UCLH and Royal Free Hospital

PERSONAL DEVELOPMENT

All staff are required to be appraised by their line managers at least once a year at a personal development review meeting where progress made over the last year is discussed and agreed. Focus on the following years departmental and personal objectives will be identified, discussed and agreed. Where necessary, help and support will be provided, and development opportunities agreed in line with service provision and knowledge and skills competency framework.
8. Health and safety

Recognise own role in meeting the requirements of the Health and Safety at Work Act

To ensure safe working practices and

• To report, without delay, all hazards, both real and

To ensure appropriate use, maintenance, cleanliness, replacement and storage of all material and

To abide by local and Trust policies and procedures with relation to health and safety.

9. Clinical Governance:

Participate in the design and implementation of the audit of clinical

Assist with the collection of statistics as required by clinical governance departments within the Trusts and within the NCL Service Level Agreement with the acute general hospitals.

Take an active role in seeking carer and user

Undertake appraisal and

Adhere to the Trust policy for the promotion of equal opportunities and cultural

Demonstrate respect, empathy and understanding of all users and colleagues within the service.

Adhere to the NMC Council Code of Professional Conduct (2015).Adhere to all Trust policies e.g. Human Resources policy, Health and Safety policy, Clinical policies and procedures.

This job description is not exhaustive but acts to provide guidelines to the duties expected of the post.

In consultation with the post holder, this job description will be reviewed and amended annually and in the light of changing professional demands.

Person Specification

Qualifications

Essential

• RMN
• OT/Social Worker/SMS clinician or RGN
• Additional qualification relevant to Acute MH care

Desirable

• Significant post qualifying experience
• Experience in CRT or Liaison
• Experience in SMS

Skills

Essential

• Excellent verbal and written skills
• Competent at using software systems (EPR, Excel)

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455-CANDI-304-E