NORTHUMBERLAND TYNE AND WEAR NHS FOUNDATION TRUST REHABILITATION SERVICE, NORTHUMBERLAND LOCALITY

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1 NORTHUMBERLAND TYNE AND WEAR NHS FOUNDATION TRUST REHABILITATION SERVICE, NORTHUMBERLAND LOCALITY Psychiatry Core Training Post (CT3) Job Description Rehabilitation and Recovery Post Base: St George s Park, Morpeth, Northumberland NE61 2NU The Service The rehabilitation and recovery service in Northumberland has both inpatient and community resources. The inpatient resource consists of 2 units: Bluebell Court and Kinnersley. Bluebell Court is made up of 15 single person flats whereas Kinnersley consist of beds for up to a total of 21 patients in a number of single person, 2 bedroomed and 3 bedroomed houses. Bluebell Court s remit is to provide intensive rehabilitation for adults between the ages of 16 65, who need in-patient based rehabilitation and are likely to need it for a period of a few months to a 2 year period. Referrals to Bluebell Court come from recovery units in St George s Park as well as community referrals from EIP, AOT and CMHTs. Kinnersley provides ongoing rehabilitation and recovery work for adults who may need a longer period in hospital than 2 years. Both take referrals directly from the acute wards in Northumberland and sometimes further afield and will also take people from Bluebell Court if it is deemed that the person is likely to need a longer period of rehabilitation. Kinnersley has a core unit within the main building for four patients who need a greater degree of supervision. The Community rehabilitation service consists of a network of residential 24 hour homes and support provided in the person s own home. There are 3 residential units based in the community which are managed by the Trust and which have close links to the rehabilitation service. These are Easterfield Court, The Willows and Acacia House. There are also close links with a core and cluster community based rehabilitation facility that is run by a charity, Blyth Star Enterprises. Blyth Star consists of a 7 bedded core unit in a residential area of Blyth. Additionally, staff from the core service also provide support to a number of service users who have their own accommodation in the community but who need an intensive level of support to manage independent living. Blyth Star staff provide anywhere from twice daily to three times a weeks support to help the person maintain their mental health in independent living. The day services within Northumberland include Ashmore House, Wellington House, and Alnwick day services. A number of people using these day services require ongoing rehabilitation and obtain psychiatric medical support from rehabilitation services. There are also a number of people living in privately run residential homes which receive support from rehabilitation and recovery service, primarily through liaison with day service staff. Page 1 of 8

2 Professional relationships Medical cover to the inpatient rehabilitation service is provided by Dr Cowan, Consultant Psychiatrist, Dr Quinn, Consultant Psychiatrist, Dr Stanbridge, Specialty Doctor, working primarily in Bluebell Court and Dr Mitford, Associate Specialist, working with Blyth Star. There is a multidisciplinary team providing rehab and recovery interventions in all three inpatient settings. These include contributions from Nursing, Psychology and Occupational Therapy. The SHO will be accountable to Dr Cowan working with all patients in Langley and Kinnersley and will also have a patient in Bluebell Court for which the SHO will be accountable to Dr Quinn, the Consultant for Bluebell Court. This will provide experience of the shorter term setting. Induction At the start of the placement you will take part in an induction programme. This will introduce you to the organisation if you have not worked for this Trust before. You will also be introduced to the workplace and informed of the requirements of the post, including the nature of your on call commitment. You will have an initial educational planning meeting with your trainer that will help you to prepare your individual learning plan for the duration of the placement. Clinical Supervision At the start of the post both you and your trainer will negotiate the level of clinical supervision required; as a guideline, for core trainees who are new to psychiatry, it is mandatory for you to discuss all patient management decisions that you make, prior to them being enacted. The name of the clinical supervisor and the nature and detail of any advice given must be clearly documented in the patient s clinical record. During normal working hours clinical supervision will be provided by Dr Cowan in relation to patients on Langley and Kinnersley and Dr Quinn in relation to the patient on Bluebell. Outside normal working hours clinical supervision is provided by the second on-call rota, which consists of both Specialist Registrars and Consultants. Day time on-call covers St George s Park site. Educational Supervision Dr Cowan will be your educational supervisor. He will provide you with regular scheduled sessions, 1 hour per week, for formal educational supervision. Duties and opportunities The duties of the post, performance criteria and the learning opportunities available are set out following the structure of the Psychiatry Specialty Curriculum (as approved by PMETB, 2006), which in turn, is based on the headings of the GMC s Good Medical Practice. Page 2 of 8

3 1. Providing a good standard of practice and care UNDERTAKE CLINICAL ASSESSMENT OF PATIENTS WITH MENTAL HEALTH PROBLEMS The core clinical commitments in rehabilitation at St George s Park will consist of inpatient work in Kinnersley unit with a further patient in Bluebell Court. You will provide the first line psychiatric assessment and review for patients in Kinnersley and also be allocated a number of patients to work with in greater depth and. You will be expected to contribute to the ongoing assessment and treatment of rehabilitation inpatients under their care. This will include regular monitoring of physical health in Kinnersley, working in association with two GP sessions provided by a local practice. You will contribute to the bio-psychosocial model of care with other multidisciplinary team members. You will undertake case note review, history taking and mental state examination, as well as physical examination on inpatients as needed and at least annually. As part of their placement you will have the opportunity to visit both voluntary and statutory sector 24 hour supported accommodation and supported living schemes. You will also have the opportunity to visit day services and attend CPA reviews of people they work with in the community. During the placement there will be an opportunity to learn more about recovery and, in particular about Wellness Recovery Action Planning, Recovery Star and social functioning assessment. You will ensure that all new patients admitted under your team s care are fully assessed, including an assessment of their physical state, so that a preliminary formulation of their problems can be made, at the latest within two working days of their admission. All in patients should be reassessed as necessary and no less frequently than once per month, so that the current status is known prior to the multidisciplinary team meetings. You will have the opportunity to use a number of assessment scales that relate particularly to working with people who have experienced psychoses. Training in communication and interview skills as appropriate to the practice of psychiatry is available and will be tailored to the needs of the post holder. You will maintain accurate and contemporaneous clinical records for all patients with whom you are involved and use the RiO electronic record system for this. MANAGE CHRONIC ILLNESS You will be expected to have an understanding of a long term conditions model of care and ensure that all investigations including regular physical health examinations for patients taking psychotropic medication are maintained as per NTW Trust policy and NICE Guidelines. This will be facilitated and supported by the MDT. Page 3 of 8

4 2. Decisions about access to care USE THE RESULTS OF THE CLINICAL ASSESSMENT TO ENSURE EFFECTIVE PATIENT MANAGEMENT Under the supervision of your clinical supervisor, you will prescribe pharmacological and psychosocial treatments for the patients that you are working with. You will refer them promptly to other professionals as directed by your experience and advice from clinical supervisors. 3. Treatment in emergencies MANAGE EMERGENCIES You will see patients who require urgent psychiatric assessment when you are on call. Additionally, during the course of your placement you will have the opportunity to assess between 4 and 6 patients who present to services following an episode of self-harm. 4. Maintaining good medical practice MAINTAIN AND USE SYSTEMS TO UPDATE KNOWLEDGE AND ITS APPLICATION TO ANY ASPECT OF YOUR PROFESSIONAL PRACTICE During the placement you will follow the Core Curriculum for Psychiatry and maintain an up-to-date learning portfolio that you will bring to meetings with the trainer when asked to do so. As a minimum, this will be at the beginning, mid-term and the end of the placement. You will participate in a weekly case conference and journal club at St George s Park. You will have the opportunity to participate in 2 weekly MDT rehab training meetings at Langley and Kinnersley. During the six months, you will personally work through at least two critically appraised topics in the journal club and will present one case at the case conference. During the 6 months you will also have the opportunity to training and opportunity to use WRAP (Wellness Recovery Action Planning) 5. Maintaining performance MONITOR AND MAINTAIN PROFESSIONAL PERFORMANCE You will participate fully in the workplace-based assessment programme of the Psychiatry Core Curriculum and will use the feedback that you receive from this process to inform your critical self-awareness. You will discuss every item of assessment with your trainer. You will participate in a weekly case discussion group as organised by the Regional Department of Psychotherapy at Claremont House. You will undertake one audit project within the rehabilitation service during the six months under the direction of your trainer. This may be supported by other medical staff within the rehabilitation service. Page 4 of 8

5 6. Teaching and training, appraising and assessing PLAN, DELIVER, AND EVALUATE TEACHING AND LEARNING IN A VARIETY OF ENVIRONMENTS You will participate in the teaching of medical students attached to the unit. This will include supporting the bedside teaching of junior and senior students by identifying and seeking the consent of suitable patients for the students to see and by assisting the students in developing their clinical skills by giving them opportunities to present and discuss the patients they have seen. You may also have the opportunity to be involved in small group teaching and lecturing to clinical medical students under the supervision of senior colleagues. ASSESS, APPRAISE AND EVALUATE LEARNING AND LEARNERS You will evaluate your own learning and progress, using self-assessment forms that you may retain in your learning portfolio. You will participate in the assessment of others, including clinical medical students and colleagues using multi-source feedback tools. 7. Relationships with patients Conduct professional patient relationships Whenever possible, you will obtain informed consent from patients for whom you provide treatment. You will observe patient confidentiality at all times. When guided by your clinical supervisors, you should share information appropriately with colleagues. Chaperones will be used when seeing patients for physical examinations. Whenever possible, and especially towards the end of the placement, you will inform your patients of the ending of your relationship with them in a timely manner. 8. Dealing with problems in professional practice CONDUCT OR PERFORMANCE OF COLLEAGUES If you become aware of problems with the conduct or performance of a colleague, you must bring this to the attention of a senior colleague. COMPLAINTS AND FORMAL INQUIRIES You must always cooperate fully with any complaints procedure or formal inquiry PROVIDING ASSISTANCE AT INQUIRIES AND INQUESTS You must always cooperate fully with any formal inquiry or inquest into a patient s death. INDEMNITY INSURANCE Early in the placement, you must discuss the provisions of the NHS indemnity insurance with your trainer. Page 5 of 8

6 9. Working with colleagues CONTINUOUSLY PROMOTE VALUE BASED NON PREJUDICIAL PRACTICE You must maintain a legal, ethical and fair approach toward working with colleagues and respect diversity. WORK EFFECTIVELY AS A MEMBER AND A LEADER OF MULTIDISCIPLINARY TEAM DEMONSTRATE APPROPRIATE LEADERSHIP During this placement you will be a full member of the Langley and Kinnersley multidisciplinary teams (MDT) and will attend their weekly meetings. You will discuss your experience of the MDT in meetings with your trainer. CROSS-COVER You will cross cover for the other core training post in the Adult Service and from time to time you may also be asked to provide cover for the staff grade doctor in rehabilitation and recovery service. COMMUNICATE EFFECTIVELY WITH OTHER HEALTHCARE PROFESSIONALS You will keep clear, accurate and contemporaneous clinical records. You will send regular written reports on patients to general practitioners and other professionals involved in patient care. Additionally you will prepare a medical summary and detailed risk assessment for patients on Langley and Kinnersley units. You will be responsible for updating these prior to the MDT meetings and prior to the end of your 6 month placement as per the agreed format. APPROPRIATELY ASSUME, DELEGATE AND DEVOLVE RESPONSIBILITY IN ADDITION TO SEEKING SECOND OPINIONS AS CLINICALLY INDICATED Your trainer and clinical supervisors will give you guidance as to the level of responsibility you should assume in individual clinical situations. If you are unsure, you must always obtain advice and assistance. 10. Maintaining probity ENSURE THAT REPORTS, EVIDENCE AND DOCUMENTS YOU HAVE A RESPONSIBILITY FOR ARE COMPLETE, HONEST AND ACCURATE Your written reports will use the standardised proformas for rehabilitation reviews, medical summaries, risk assessments and discharge letters. Outpatient letters should be sent within 2 weeks of the consultation, interim discharge summaries faxed on the day of a patient s discharge and full discharge summaries sent within 2 weeks of the discharge. Full discharge summaries will be countersigned by the consultant or associate specialist. During the course of your placement you will produce a medical summary and risk assessment on a number of new patients. You will also be asked to update the summaries/risk assessments on your patients. You will also be responsible for updating the physical health records for all patients on Langley and Kinnersley and your allocated patient on Bluebell. Page 6 of 8

7 Unless instructed otherwise, all reports that you write must be checked by one of your clinical supervisors before being sent out. You will not provide any other written reports about patients unless this has been sanctioned by one of your clinical supervisors. PROPERLY MANAGE FINANCIAL AND COMMERCIAL DEALINGS You must report the receipt of any gift from patients under your care with your trainer and you must not solicit any fee or payment from a patient or third party unless your trainer has sanctioned this. You will not meet with any representatives of the pharmaceutical industry during work time, unless this is at a postgraduate meeting that has been organised within ABPI Guidelines. AVOID CONFLICTS OF INTEREST AND ADVISE OTHERS ON PREVENTING AND DEALING WITH CONFLICTS OF INTEREST You must inform your trainer of any real or potential conflict of interest you may have currently or that you identify at any stage during your work with NTW Trust. 11. Health ENSURE THAT YOUR HEALTH AND THE HEALTH OF OTHERS DOES NOT PUT PATIENTS AT RISK You must always obtain advice and treatment for mental and physical health problems and must ensure that your health does not put patients at risk. You must comply with the Trust s occupational health policy. Page 7 of 8

8 Typical weekly programme NB; this programme is provisional only and may vary in the light of both the trainee s learning needs and the needs of the clinical service. MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY AM Trainee Forum (monthly) Case Conference / Journal club ECT x 2 (March only) Kinnersley MDMs MRCPsych programme / clinical work Every other week during university term 9-11 Clinical work Supervision with Dr Cowan ECT x 1 (Apr, May, Jun) x 3 (July) Medical summaries PM Clinical work Kinnersley troubleshooting and minireviews MRCPsych programme / clinical work Every other week during university term Langley ward review 2-3 Langley MDMs and reviews Psychotherapy supervision Teaching tutorial weekly, various days. JD Updated Oct 12 Page 8 of 8

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