Consultant Psychiatrist in Medical Psychotherapy

Employer
Mersey Care NHS Foundation Trust
Location
Waterloo
Salary
£84,559 to £114,003 a year per annum
Closing date
28 Jun 2022

View more

Profession
Counsellor / Psychotherapist
Grade
Consultant
Contract Type
Permanent
Hours
Full Time
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The Trust is seeking a full-time consultant psychiatrist in medical psychotherapy/general adult psychiatry to join the specialist personality disorders services based at Spring House. This new post has been created to support the planned expansion to the PD Case Management Team to cover the geographical areas of Warrington + Halton in the recently expended Trust.

It is envisaged that the post-holder will joint the current 1.8 consultant psychiatrists and work across all 3 services based at Spring House.

The service prides itself in creating a community for service users attending Spring Hose, through both the stabilisation and therapy stages of their recovery. The team is welcoming, has good supportive structures in place and currently has a well motivated team with good staffing levels and high levels of retention. The team is also works innovatively in response to challenges and developments. The service has been recognised locally and nationally as an area of excellent practice (recently making the final of 5 national awards including being the runner up twice in the Health Service Journal Awards 2019 and 2021.).

Main duties of the job

Supporting the intensive community PD Case Management Team that offers 100 weeks of intensive care co-ordination to those patients with the most complex presentations, to divert patients from Out of Area Placements and local inpatient wards. The new Consultant Medical Psychotherapist/Psychiatrist will act as the Responsible Clinician (RC) for the service users attending the service bringing together the psychological and medical care within a single service.

Working into PD Therapeutic Day Service and PD Crisis Service that provide social therapy and crisis support across the week and into evening.

Working into the psychotherapy service offering assessments, on-going therapy and supervision/training to trainees from different disciplines.

The aim has been to develop an integrated range of services, delivered from the same building, which service users will be able to form an attachment to as an alternative to hospital admission. The overarching philosophy of the service will be to help service users become more responsible for their own actions, promote personal independence and support therapeutic risk taking.

About us

Mersey Care is one of the largest trusts providing physical health and mental health services in the North West, serving more than 11 million people.

We offer specialist inpatient and community services that support physical and mental health and specialist inpatient mental health, learning disability, addiction and brain injury services. Mersey Care is one of only three trusts in the UK that offer high secure mental health facilities.

At the heart of all we do is our commitment to 'perfect care' - care that is safe, effective, positively experienced, timely, equitable and efficient. We support our staff to do the best job they can and work alongside service users, their families, and carers to design and develop future services together. We're currently delivering a programme of organisational and service transformation to significantly improve the quality of the services we provide and safely reduce cost as we do so.

Job description Job responsibilities

This is a new post, for a full time Consultant Medical Psychotherapist/General Adult Psychiatrist, who will join the current full time Medical Psychotherapist (Clinical Lead) and 0.8 WTE Consultant General Adult Psychiatrist within the Psychotherapy and Personality Disorder (PD) Hub Service based at Spring House.

The recruitment of an additional new Consultant Medical Psychotherapist/General Adult Psychiatrist will support the expansion of the PD Case Management Team to cover the Warrington and Halton areas of the Trusts geographical footprint, following merger with the neighboring Trust.

It is in visage that the post-holder will work across all the different services described below and help with the establishment and development of the new PD Case Management service into Warrington and Halton, with the support of the Clinical Lead. This will involve establishing new links with the other inpatient and community services in this area.

Duties within the Psychotherapy Service:

Expert knowledge in psychological formulation and assessment, and the delivery of specialist psychological interventions.

Screen referrals.

Psychotherapy assessment and formulation.

Psychotherapy interventions, with specialist knowledge/skills in at least two modalities of therapy, including a specialist knowledge of PD interventions (e.g. MBT, DBT, SCM, TC, CAT, Psychodynamic Therapy). Personal case load of 4-6 cases.

Provision of Psychotherapy Training to medical trainees (e.g. Balint Groups + supervision groups) and those from other disciplines (e.g. supervision).

Historically, the Trust has had a Psychotherapy Service, delivering a range of both conventional psychotherapies (CBT, CAT, Family Therapy, Psychodynamic Individual and Group Therapy) and specialist interventions for PD (MBT, DBT, Day Therapeutic Community, CFT). There are 7 whole time equivalent psychotherapist working in the psychotherapy service at the moment, including the overall Service Manager. Additionally, there is a CT medical trainee in a shared post with the Homeless Outreach Team and two ST trainees undertaking dual training in General Adult and Psychotherapy over 5 years. The Psychotherapy Service is only open to referrals from within the Trust and operates a quota system of 25 referrals a month, mostly from CMHTs, to ensure that there is a match between referral rate and the services clinical capacity. Primary Care patients are seen in the local IAPT and Step Forward services.

Duties within the PD Case Management Team:

Consultation to other teams + Out of Area Treatment (OATs) gatekeeping assessments

Provide community RC role, including CPA reviews, for up to 20 service users under the care of the PD Case Management Team. It would be expected that clinical work would be covered within a single out-patient-clinic, seeing two patients, who might be new or for follow up cases. It is envisaged that a satellite OP clinic will run within Warrington + Halton.

Also to be the responsible clinician for the purposes of the Mental Health Act 1983 (amended 2007) and carry out duties in accordance to the code of practice.

To conduct patient reviews and lead Multidisciplinary team reviews, CPA reviews and multi-professional meetings.

Be responsible for the prescription of medication for service users under the care of the team.

To carry out comprehensive Risk Assessments and participate in Trusts risk management processes such as Health Risk Assessment and Management Meetings (H-RAMM) and Multi Agency Public Protection Arrangement (MAPPA) Meetings.

Provide clinical supervision to the PD case managers, two-weekly.

Developments by the Trust 6 years ago saw the establishment of a community PD Case Management Team (3 nurses delivering care to 30 complex service users with high rates of hospital admission). Two new nurses will be appointed to cover the Warrington and Halton areas of the trust. This service offers 100 weeks of intensive care co-ordination to those patients with complex presentations within the Local Services, to divert patients from Out of Area Placements and local inpatient wards. This service works to its clinical capacity, only taking patients on when there are spaces available. One to two referrals are received a week and consultations are offered if the team does not have space to take the service users on directly. The PD Case Management Team has a separate referral pathway, but again works to its clinical capacity of 10 service users per case manager. Linked to this each consultant will have up to 20 patients under their care. There is no sectorization to the provision of care at Spring House currently, but this might be considered when a third consultant joins the team.

Duties within the PD Day + Crisis Service:

There are around 130 patients registered with the PD Hub Day Service at any one time. Assessments and routine reviews are routinely managed by the nursing team.

The Crisis Service gate keeps three beds at Stepping Stones and all routine assessments related to this are undertaken by the nursing staff.

Participate and support the running of the Day Service by joining the steering groups on a Friday.

Support the crisis service (e.g. joining the morning shift hand over once per week)

Clinically reviewing service users within the PD Hub on an occasion basis when a complex or risk related issue indicates this.

Five years ago a PD Social Therapy Day Service (utilizing therapeutic community principles), combined with a dedicated Crisis Service, was established, run be 12 members of staff working across both services. These are open into the evening seven days a week. In March 2021, the Crisis Service became the gatekeeper for three dedicated respite/Crisis beds, run in association with the YMCA and based in Garston Liverpool. These crisis beds provide respite for up to 2 weeks, and can be booked in advance for anticipated periods of difficulty or used urgently.

Leadership:

The post holder will be expected to provide medical leadership and support the clinical lead in ongoing developments within the Psychotherapy and PD Hub and support the Trusts strategic aims of delivering Perfect Care and participate in service/team evaluation and the planning of future service developments.

Training:

There is currently a Psychotherapy CT (split with the Homeless Treatment Team) who is in the department 2 days per week and 2 dual ST trainees in Psychotherapy and General Adult who rotate into the Psychotherapy Service for 3 out of their 5 years of training. Recently, 2 GP trainees are also allocated to work within the team, 2 days per week each. In addition, there are also many other CT trainees attending psychotherapy supervision and Balint groups. The post holder will be expected to be involved in the psychotherapy training of junior staff (provision of training through Balint groups, leader and/or supervisor of psychotherapy supervision groups).

Research:

Spring House has an active research culture across the service, with several members of the team undertaking/leading research (e.g. psychotherapy for medically unexplained symptoms) and writing papers for publication (e.g. service evaluations), often with the involvement of trainees on placement. There is a formal research link established with a senior lecturer at the University of Central Lancashire, who collaborates with projects and shares their expertise. The day service also encourages service users to be collaborators in designing and running research projects and a monthly meeting with them helps steer such projects. Spring House is currently collaborating with a company in Norway to install a software system that will see around 30 outcome measures used across all the different services.

On call:

The appointee will take part in the on call Consultant duty rota, which is combined for General Adult and Learning Disability. Separate rotas exist for the north and south geographical areas of the Local Division and the successful candidate will join the north rota. The frequency of the rota is currently 1 in 12-14 per WTE.

Person Specification Qualifications Essential
  • Basic medical qualification
Desirable
  • MRCPsych
  • Higher educational or research-based qualification
  • To have a recognised psychotherapy qualification i.e. Post Graduate Diploma in Psychotherapy and additional training in specialist PD Interventions (e.g. MBT, DBT, SCM, CAT)
  • UKCP or BACP accredited (or equivalent)
Transport Essential
  • Holds and will use a valid UK driving licence or provides evidence of proposed alternative
Eligibility Essential
  • Full GMC registration
  • 3-5 years higher professional training in general adult psychiatry and/or psychotherapy
  • Registered as a Specialist in Medical Psychotherapy and/or General Adult Psychiatry on GMC Specialist Register or eligible for inclusion within 6 months
  • Section 12(2) Approval / Approved Clinician Status or demonstrated ability to gain approval
Desirable
  • Registered as a Specialist in both Psychiatry and Medical Psychotherapy (Dual Training) on GMC Specialist Register or eligible for inclusion within 6 months
  • Management training or qualifications
Clinical Skills, Knowledge and Experience Essential


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    350-MED4259539
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