This post is for a full-time consultant psychiatrist working into a well-established community mental health team covering the Durham & Chester-le-Street sector. It is a replacement post following the retirement of the previous post-holder. The Durham & Chester-le-Street community team sits within the Durham, Tees Valley & Forensic Care Groups MHSOP service.
Main duties of the job
This post is for a 1.0 WTE consultant working into the Durham & Chester-le-Street CMHT based at the Bowes Lyon Unit at Lanchester Road Hospital in Durham. The post holder will provide consultant psychiatric input to a population of 30,658 people over 65 years in the local area, shared with another consultant colleague, Dr Arunima Ghosh, and a specialty doctor, Dr Lucy Gardner. Dr Nhish Gurunathan, an inpatient consultant at the Bowes Lyon Unit, also provides some consultant sessional input into this team, as does Dr Jessica Beard via a flexible contract. The consultant workload is predominantly divided into sectors based on GP Surgeries, which are divided amongst the consultants in proportion to their time with the team. This allows the longitudinal development of strong working relationships with local communities and primary care colleagues. Both teams provide mental health services to older people with mental health problems and frailty-related complexities. We also accept referrals for young onset dementia patients. Each team has administrative support and co-located social workers. The team uses the Care Programme Approach (CPA) to ensure regular reviews and risk assessments are completed, with supervision in place in accordance with trust policy.
We are one of the largest specialist mental health and learning disabilities trusts in the country, with an annual income of £320m and a workforce of some 6,700 staff operating from around 100 sites in Durham, Teesside, North Yorkshire and York and Selby. We provide a range inpatient and community services to 2m people living in County Durham, the Tees Valley, Scarborough, Whitby, Ryedale, Harrogate, Hambleton and Richmondshire. We also provide additional specialist services to other parts of Northern England.
We deliver our services by working in partnership with eight local authorities and clinical commissioning groups, a wide range of voluntary organisations, as well as service users, their carers and the public. The services are spread over a wide geographical area of around 3,600 square miles, which includes coastal, rural and industrial areas.
We are a multi-award winning trust and are included within the Health Service Journals Best 100 Places to Work. The trust take a positive and proactive approach to support staff in their personal development and has embedded the Talent Management approach within the Trust, with the vision of helping people to be as good as they can be, helping TEWV to do things better.
Job description Job responsibilities
The attached programme indicates fixed sessions that would be appropriate but a definitive job plan in line with the new consultant contract will be agreed with the post holder on commencement. A yearly job plan review including evaluation will take place with the Clinical Director and Head of Service for the specialty. The process will need to be further developed to take into account all the requirements of revalidation.
The Clinical PAs are 7.5 PA across the week at the Bowes Lyon Unit in Durham. This post provides consultant leadership to the Durham & Chester-le-Street community team, working closely with other consultant colleagues for these teams.
The post-holder will be responsible for the delivery of mental health services to the population of older people of approximately 30,000 shared amongst 3 consultants (including this post) providing a total of 1.75 WTE consultant input. The Consultant is an integral member of enthusiastic and well managed multi-disciplinary teams operating in community and inpatient settings. There is a need for a flexible approach to a pattern of working which may change from time to time depending on the demands of the various areas of the service. There will be a requirement to undertake some home visits. The post holder will provide clinical supervision to a core trainee. It is expected that the post holder will carry a small personal caseload of around 20 patients (across both teams), with the team members being care coordinator for most patients, reviewing that care with the consultant in line with new ways of working. The weekly workload for the consultant will consist of around 2 new patient assessments, with flexibility to respond to urgent referrals, face to face support to the team in meetings and ad-hoc, around 15 face to face reviews of community patients either at their home or in clinic with actual numbers dependant on the complexity of each CPA review. The approximate anticipated annualised workload of current post holder of the job advertised is in the region of 50 Initial Assessments, 500 Reviews & Diagnostics (inclusive of home-visits) and 20-30 Mental Health Act assessments. However, these numbers are used as a guideline only, as it is recognised that the needs of patients may dictate a need for more review appointments than new patient appointments or vice-versa. Most initial assessments are undertaken by nursing staff, with consultants usually only assessing the more complex referrals.
The post-holder is expected to be the Responsible Clinician for any patients on CTOs within the patch, though this number has remained historically low; at present, no consultant has more than 1 patient on a CTO at any time. The post-holder is expected to prioritise Mental Health Act Assessments for their own patients during working hours, and be a qualified DOLS Mental Health Assessor for any patients on their personal caseload. Occasionally, there may be ad hoc Section 49 Mental Capacity Act reports to prepare, and these are shared evenly amongst the consultant body. Therefore, it is necessary for the post-holder to have Approved Clinician, Section 12 and DOLS Mental Health Assessor Status, and support can be provided to attain the latter if the prospective applicant does not already hold this status.
The appointee will be part of an on-call rota for mental health services across North Durham. With this appointment there will be a 1:18 (pro rata) on-call commitment. On-call is classed as Category A with a 3% on-call supplement payable or time in lieu. Holiday cover is provided by prior arrangement with Consultant colleagues and may be from any of the senior medical staff within North Durham.
The postholder will be expected to have a familiarity with important relevant legislation affecting the care of older people with mental illness. The Trust is eager to support the development of a special interest and this is negotiable either at the time of employment or at the Annual Job Plan Review meeting. The postholder will work with the Locality Manager, Head of Service and Clinical Director to plan and develop the service in line with the Trust Integrated Business Plan.
There are 2.5 supporting PAs with active encouragement to use these for some of the following activities.
Educational and academic duties of post holder
Participation in the undergraduate teaching of medical students and physician associates on placement within the team
Supervision and training to core trainees whenever they work in the community.
Supervision of the specialty doctor in the team
Participation in postgraduate teaching programme
Participation in clinical audit and service evaluation
Participating in consultant peer group
General professional duties of post holder
Maintain good clinical records using Trusts electronic record system
Undertake administrative duties associated with the care of patients
Record clinical activity accurately and comprehensively
Maintain a revalidation portfolio and participate in annual appraisal
Undertake a job plan review with the Lead Psychiatrist and Service Manager annually
Maintain professional registration with the GMC and approval as an Approved Clinician and Section 12(2) approved doctor
Comply with Trusts agreed policies and procedures
Leadership duties of post holder
Provide support to consultant clinical leadership of the multi-disciplinary team
Will be participating in the Leadership Hub of the team
Contribution to service development
Contribution to clinical governance and responsibility for setting and maintaining standards
Commitment to quality improvement
External duties, roles and responsibilities
The Trust actively supports the involvement of the medical workforce in regional and national groups subject to discussion and approval with the Associate Medical Director, and as necessary, the Medical Director and Chief Executive.
From time to time it may be necessary for the post holder to carry out other such duties as may be assigned, with agreement, by the Trust. It is expected that the post holder will not unreasonably withhold agreement to any reasonable proposed changes that the Trust might make in line with the job planning process.
Person Specification Clinical Knowledge & Skills Essential
- Excellent knowledge in specialty
- Excellent clinical skills using bio-psycho-social perspective and wide medical knowledge
- Excellent oral and written communication skills in English
- Able to manage clinical complexity and uncertainty
- Makes decisions based on evidence and experience including the contribution of others
- Able to meet duties under MHA and MCA
- Wide range of specialist and sub-specialist experience relevant to post within NHS or comparable service
Academic Skills and Lifelong Learning Essential
- Able to deliver undergraduate or postgraduate teaching and training
- Participated in continuous professional development
- Participated in research or service evaluation.
- Able to use and appraise clinical evidence.
- Has actively participated in clinical audit.
- Able to plan and deliver undergraduate and postgraduate teaching and training relevant to this post
- Reflected on purpose of CPD undertaken
- Experienced in clinical research and / or service evaluation.
- Evidence of achievement in education, research, audit and service improvement: awards, prizes, presentations and publications.
- Has led clinical audits leading to service change.
- Holds and will use valid UK driving licence OR provides evidence of proposed alternative.
- Reflects on own performance and behaviour, seeking and acting on feedback.
- Able to influence and persuade to improve services
- Able to take on leadership role in multidisciplinary team.
- Knowledge of structure and management of the NHS and the Trust.
- Shows commitment to quality through knowledge of quality improvement and lean thinking methodology OR able to achieve within one year of appointment
- Able to adapt to and lead service change.
- Able to take on a leadership role outside the multidisciplinary team.
- Understanding of NHS & wider health economy and its implications for the work of the Trust.
- Trained to standard equivalent to level 2 in TEWV Trust Quality improvement system
- MB BS or equivalent medical qualification.
- Qualification or higher degree in medical education, clinical research or manageme
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