StR/ SpR POST DETAILS 2009-2010

DETAILS OF PLACEMENT:

This is a specialist registrar post in general adult psychiatry located within a district general hospital providing a service to a population of 217,000. The service is fully sectorised and the post covers all aspects of general adult psychiatry.

Although the post is predominantly hospital based there is the opportunity for community experience through existing close clinical links with the community mental health teams. The community mental health team has been sectorised into two teams, North and South. The community mental health team is, at the moment, in the process of changing with the new CPA Policy based on complexity and risk. The post covers one half of the South Sector. There is a fortnightly community review meeting and a similar meeting involving a psychiatric day hospital to which the SpR would be invited to participate.

The post provides opportunities for a wide-ranging experience of district general hospital psychiatry. There is an emphasis on the care programme approach, on maintaining close relationships with general practitioners, and on family liaison. The post holder will join colleagues to take part in providing a liaison service to medical and surgical specialities within the district general hospital. There are opportunities for forensic work including preparation of Court reports and close working with a specialist mentally disordered offenders team.

The SpR would be exposed to a case-mix comprising severe psychotic disorders, severe and resistant depressive illness, dual diagnosis patients and a small caseload of patients with personality difficulties. The post holder will have the opportunity to develop skills and experience in working with these client groups.

There is an active educational programme, which is well attended by all consultants and SpRs and includes case conferences, video training and journal clubs.

Training is available in psychological work including cognitive behavioural therapy, dynamic psychotherapy and family intervention work. There is an active department of psychology at Birch Hill Hospital site where opportunities exist for clinical research in collaboration with psychology colleagues.

DETAILS OF EXPERIENCE TRAINEE WILL GAIN AND MAIN DUTIES:

The role of the trainee

1. Outpatient work: the trainee will build up his or her own caseload. One new patient will be allocated to a separate clinic each week.

2. Supervision of in-patients: the trainee will manage a small caseload of patients under consultant supervision. Day to day management will be handled by the SHO. The trainee would attend weekly ward rounds and one managers round.

3. Community team meetings: these are arranged fortnightly.

4. CPA reviews: the trainee will attend CPA reviews for patients on their caseload.

5. Management training: the trainee will be invited to attend directorate meetings, and strategy group meetings attended by their trainer.

6. On-call duties: participation as second on call in a 1:6 rota with consultant cover.

7. Emergency work: Mental Health Act assessments and urgent community reviews conducted with community professionals.

8. Supervision: there will be one hour of individual supervision per week with the trainer, Dr Etuk, and a formal review of progress every 3 months.

CLINICAL WORK:

CLINICAL DUTIES

Outpatients:
Two out-patient follow-up clinic per week. One new patient seen in a weekly clinic attended by SpR, and SHO.

In-patients:
Opportunities for in-patient work. The post holder will be expected to be responsible for the management of patients on their caseload who are admitted to hospital. Opportunities exist to supervise junior medical staff in respect of in-patient work.

Liaison psychiatry:
Assessment of referrals from medical and surgical specialties under the supervision of the consultant trainer. There is an Access & Crisis Team in place who usually see cases of DSH and overdoses, but the SpR may be required to offer consultation in difficult cases.

ON CALL COMMITMENT AND PAY BANDING

The SpR will be expected to be involved in emergency and urgent community assessments including assessments under the Mental Health Act. Majority of these involve close liaison with community mental health team colleagues. The SpR will participate as 2nd on-call on a 1-in-6 rota.

TEACHING / ACADEMIC EXPERIENCE:

• Medical students- one final year medical student did a placement
• Foundation trainees- 2 trainees with other teams
• ST trainees- yes

The SpR would be encouraged to participate in the weekly educational half-day programme, which presents opportunities for teaching junior medical staff and allied professionals. There will be the opportunity for informal teaching of junior medical staff within the trainer’s own team.
Also a 5th year medical student is usually attached to the Educational supervisor’s team and the trainee will have ample opportunity to be involved with teaching of medical students.

ACADEMIC ACTIVITES:

Weekly case conferences and Journal club meetings. Balint group meets twice a month. Educational meetings at the Rochdale infirmary once a month.

FACILITIES:

The SpR will have an office with full computer facilities within the department building. There is full-time secretarial support. There is a well stocked departmental library and a Trust library located in the postgraduate centre at the nearby Rochdale Infirmary. This provides facilities for study and research including literature searches, and Internet services. The library also offers a range of traditional services including photocopying and inter-library loans. The department has facilities for making and viewing recordings of interviews for the purpose of interview training.

SUPERVISION ARRANGEMENTS:

There will be one hour of individual supervision per week with the trainer, Dr Etuk.
Supervision of in-patients: the trainee will manage a small caseload of patients under consultant supervision.

AUDIT/RESEARCH OPPORTUNITIES:

Trainees are encouraged to conduct audits and present them locally.

MANAGEMENT TRAINING:

The service is evolving and currently going through a period of organisational change. The Assertive Outreach Services has been upgraded with a new Consultant taking charge. There is also a recently employed Consultant in Substance Misuse. Further plans for service development include an early intervention service, crisis resolution/Home treatment team and development of existing intensive care facilities.

There will be the opportunity for the SpR to play a role in these service developments and to attend planning meetings. The SpR will be encouraged to attend local departmental management meetings and similar meetings within the acute Trust based at the Rochdale Infirmary. The SpR will be encouraged to attend management courses.

SPECIAL INTEREST OPPORTUNITIES:

This is a Core General psychiatry post but there are opportunities for Crisis work, Early intervention and Assertive out reach work.

PROBABLE TAMETABLE (EXAMPLE OF COMMITMENTS)

IMPORTANT ADDITIONAL DETAILS:

This is a core training post.