JOB DESCRIPTION
CONSULTANT PSYCHIATRIST,
NHS WESTERN ISLES
(Full Time)
1. THE WESTERN ISLES
The Western Isles , otherwise known as the Outer Hebrides, lie approximately 30 miles off
the West Coast of Scotland and consist of several larger inhabited Islands with a multitude of
uninhabited small islands . The main islands are Lewis, Harris, the Uists and Barra, with a
total population of 27,400 They are easily accessible by ferry from Ullapool, Skye and Oban.
There is an excellent air service from Aberdeen, Inverness, Edinburgh and Glasgow. There
is a bus service to Inverness from Ullapool which runs in conjunction with the ferry
timetables and links with rail services from Inverness.
There is a regular internal air service connecting Stornoway to the Uists and Barra.
Stornoway is the administrative “capital” of the Western Isles. It has a population of
approximately 8,000 and has all the facilities one would expect to find in a town of this size.
There are many primary schools on the islands as well as secondary schools. They are all
well equipped and have a good reputation for academic achievement. Adult education is
provided through the Lews Castle Technical College which is part of the University of the
Highlands & Islands. Degree courses are available at the College. The Islands still retain
their unique Gaelic speaking heritage.
2. OSPADAL NAN EILEAN (WESTERN ISLES HOSPITAL)
The Western Isles Hospital is one of six Rural General Hospitals in Scotland and serves the
Outer Hebrides area. The hospital was opened in 1992, is modern and well equipped. The
Western Isles Hospital is one of three hospitals located in the Western isles; St Brendan’s in
the Isle of Barra, the Uist and Barra Hospital in Benbecula and the Western Isles Hospital, in
Stornoway. The Western Isles Hospital is the main hub hospital which has 96 beds covering
specialties in General Medicine, General Surgery, Orthopaedics and Trauma, Obstetrics and
Gynaecology, Psychiatry, Paediatrics and Radiology.
The Western Isles Hospital has an up-to-date laboratory service covering the main
disciplines of haematology, microbiology and biochemistry with ready access to more
specialised investigations at Raigmore Hospital, Inverness, and other specialised
laboratories in Scotland.
The Radiology Department is well equipped for routine radiology, CT scanning, ultrasound
and Doppler studies.
Locally based consultant services
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General Medicine
General Surgery,
Orthopaedics
Anaesthesia
Paediatrics
Obstetrics and gynaecology
Psychiatry
Radiology
Dental Services
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A&E, covered by enhanced roles GPs out of hours and junior doctors/consultants in
hours
Visiting consultant services
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Respiratory Medicine
Rheumatology/rehabilitation
Dermatology
Oncology
Neurology
Ophthalmology
Renal Medicine
Otolaryngology
Urology
Child & Adolescent Mental Health
Tertiary referrals
The main referral centres are in Inverness and Glasgow, but other hospitals in Scotland are
used when necessary in accordance with Service Level Agreements and via extra
contractual referrals.
3. DEPARTMENT OF PSYCHIATRY
NHS Western Isles’ mental health services are currently in the process of change. It is
intended ,that in the future, service delivery will be focused more on the provision of mental
health services in the community. The post holder will have a major influence in the
formulation and implementation of these changes.
The present community resources consist of a Community Mental Health Team based in
Stornoway covering the co-joined Islands of Lewis and Harris and one Community
Psychiatric Nursing (CPN) team in Benbecula covering the Islands of Uist and Barra.
The Stornoway team consists of 4 CPNs 1 Social worker with Mental Health Officer Status, 2
community learning disability nurses, 2 substance misuse nurses (with hospital liaison
remit), 2 post diagnostic (dementia) link workers, 2 part time counsellors and 2 Community
Learning Disability Nurses.
The Benbecula team consists of 3 CPNs and 1 substance misuse worker.
There are a number of social workers who are designated as mental health officers in terms
of the Mental Health (Care and Treatment) (Scotland) Act 2003 who are employed by
Comhairle nan Eilean Siar (Western Isles Council). There is a close working relationship
with the social work department. An Integration Scheme between NHS Western Isles and
the Comhairle nan Eilean Siar has been submitted to the Scottish Government. It
explains which health and care services will be delivered jointly by the NHS and the
Comhairle. Mental Health services will be integrated in 2016.
The mental health inpatient facilities are based in the Western Isles Hospital in Stornoway.
This consists of a 5 bed acute psychiatric ward and a 14 bed ward for people who exhibit
severe behavioural and psychological symptoms of dementia There are , at present, plans
for major works to upgrade these facilities and there is the potential to relocate these
facilities outside the hospital environment. The post holder will have involvement in the
planning and implementation of these developments.
Psychiatric out-patient clinics are held in a variety of locations across the Western Isles, both
hospital based and GP surgeries.
Currently there is no dedicated psychological therapy service and psychological therapies
are provided from generic teams. It is envisaged the modernisation programme will make
psychological therapy provision more robust.
4. THE POST
The post holder will be involved in assessment and treatment of people suffering from
mental health disorders within the Western Isles area. This would include a consultative role
and clinical supervision of colleagues. This will involve work both in the community and in
the hospitals.
There is another consultant psychiatrist in post who works in adult general psychiatry. The
post holder will provide cross-cover for his/her consultant colleague for absences including
annual leave, study leave, administrative meetings on the mainland, and trips to other parts
of the Western Isles. This arrangement will be reciprocal. The Post Holder will initially have
his/her office in the Western Isles Hospital with full time secretarial support.
The Consultants currently share responsibility for on-call duties (1:2). NHSWI has a well
developed enhanced role GP OOH system, in which these GPs are first on call for
psychiatry and deal with most cases without consultant input, along with an experience team
of Clinical Specialist Nurses. The need for on island consultant psychiatrist provision is
currently being reviewed by the modernisation program’s clinical reference group. The
opinion of the post holder will be important in this respect.
It is expected that the post holder and his/her consultant colleague will participate in
professional development with their colleagues on the mainland.
The post holder is expected to use and develop tele-consultation with colleagues elsewhere
in the western Isles and in mainland facilities. The post holder will also be expected to
develop the use of tele-health facilities to consult with patients.
Consultants will be required to participate in appraisal and job planning
The post-holder is required to effectively participate in and promote all appropriate SPSP
bundles and safety measures.
RESEARCH
The Post Holder will be encouraged to undertake research in areas of interest relevant to the
delivery of health care in the Western Isles. It is hoped that the post holder will play a part in
the development of the concept of rural psychiatry.
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CONTINUING PERSONAL DEVELOPMENT
The Post Holder will be expected to identify their requirements for, and engage in, continuing
personal development. Opportunities to link in with mainland programmes will be supported
and funded as appropriate.
CLINICAL GOVERNANCE
The conducting of regular clinical audit and the supervision of clinical audit by junior staff is
part of the Consultant’s responsibility supported by the Medical Director and General
Manager. The post holder will be expected to provide clinical leadership on the
implementation of local and national strategy and initiatives pertaining to mental health.
CONTRACTUAL DETAILS
The post holder will be professionally responsible to the Medical Director and managerially
responsible to the General Manager.
The two consultants in the department will agree arrangements for cover of duties.
The terms and conditions of service applicable to this appointment are the Consultant grade
terms and conditions of service as amended from time to time.
NHS Western Isles will require each consultant to agree with the Medical Director and
General Manager, a job plan of fixed and other commitments, which will be reviewed on an
annual basis and revised as necessary to meet the requirements of local and national
service issues.
Formal appointment to this post will be conditional upon satisfactory completion of all preemployment checks, including satisfactory medical screening.
The successful candidate will be expected to be registered for CPD with the Royal College
of Psychiatry and to fulfil requirements for annual certification and for appropriate General
Medical Council revalidation.
It is essential for the post holder to be eligible to be an Approved Medical Practitioner under
Section 22 of the Mental Health (Care & Treatment) (Scotland) Act 2003. If the appointed
Post Holder is not an approved Medical Practitioner under the terms of this Act then NHS
Western Isles will provide access to training to obtain this Certificate. It is expected that the
Post Holder will take advantage of this opportunity as soon as practical.
Annual leave entitlement is 42 days per year (12 of which are weekends), with additional
statutory holiday entitlement as agreed by the Local Negotiating Committee.
PSYCHIATRIC CARE TO BE PROVIDED BY POST HOLDER
The Post Holder has an opportunity to take part in and develop psychiatric care in an
exceptionally remote but beautiful area of Scotland. It is the hope that the post holder would
help to develop the concept of “rural psychiatry” delivering psychiatric health care in an
integrated way to a remote and rural area.
The post holder would have an input into different areas of psychiatry.
CARE OF THE ELDERLY
The population for the Western Isles is 27,400 of which 6,266 are over age 65 . Patients
with severe behavioural and psychological symptoms of dementia can be assessed and
treated in Clisham Ward, Western Isles Hospital. Currently Clisham ward provides 14 beds
but this number will reduce as the service shifts towards a community focus. Patients with
dementia may be admitted to the Uist and Barra Hospital and St Brendan’s Hospital, Barra.
All local authority care homes are equipped to meet the needs of people with dementia,
though two have specific Dementia Units providing long term and respite beds for Dementia
sufferers. A total of 17 long stay beds are allocated to Dementia units with 3 respite beds.
The Local Authority provides 127 residential care beds and fund 79 privately owned or third
sector beds.
Day care is not provided exclusively within Residential Care facilities, but through a
combination of service provision within local authority owned Care Units & Day Centres, and
through third sector provision. Day Care services are provided as hours of service rather
than specific day care places.
The Post Holder will have a major input into the care of elderly patients with psychiatric
problems both organic and functional. The Post Holder will be responsible for providing
clinical leadership to Clisham ward and in providing outpatient clinics in Stornoway, Uist and
Barra. The post holder will also provide a liaison service to the Local Authority and private
homes and in the community. The Post Holder will be expected to maintain good working
relationships between the mental health services, acute services and the various 3rd sector
and local authority departments, and local general practitioners.
The Post Holder will take part in the development of new arrangements for the care of
elderly people with psychiatric problems. The Post Holder will have a major impact on the
delivery of these new services. More of the services will be delivered in the community by
Community Psychiatric Nurses, support workers and other auxiliary staff.
It is expected the Post Holder will devote approximately 5 sessions to this task, according to
agreed job plan.
LEARNING DISABILITY
There are no designated beds in the Western Isles for inpatient treatment for the psychiatry
of learning disability although the acute ward may admit patient with learning disability who
experience acute psychiatric illness. The NHS Western Isles has a service level agreement
to admit patients to New Craig’s Hospital in Inverness. The Post Holder would be expected
to have a close working professional relationship with mainland colleagues.
The Post Holder will assess patients with a learning disability in clinics and in the community.
It is expected that the post holder will work to develop better community assessment and
treatment facilities working closely with the community learning disability nurses (CLDNs)
GENERAL ADULT PSYCHIATRY
The Post Holder would be expected to see some General Adult Psychiatry patients. The
post holder will work closely with his colleague in the clinical leadership of the Acute
Psychiatric unit.
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DRUGS & ALCOHOL PSYCHIATRY
Alcohol abuse is a significant problem in the Western Isles. The post holder would be
expected, with the other consultant psychiatrist, to support and develop the service which
includes seeing people as outpatients and in their own homes. The post holder will, support
the alcohol liaison mental health nurse
and the community alcohol detox nurse, the
substance misuse Co-ordinator, GPs and the local social work department in the provision of
services to people with addiction problems
LIAISON PSYCHIATRY
The Post Holder would be expected to share the responsibility for liaison psychiatry in the
Western Isles Hospital, Uist & Barra Hospital and St Brendan’s Hospital, Barra with his/her
colleague. This will include support of the junior doctors and on call enhanced role GPs on
assessing overdose assessment and suicide risk and in the support and development of
liaison psychiatry provided by trained non-medical personnel.
The post holder, with his/her colleague, will advise GPs in Uist and Barra on patients with
psychiatric problems admitted to the community hospitals there. The post holder will work
closely with the CPNs in helping the GP s assess and treat patients in hospital there.
GENERAL ASPECTS
It can be seen that the Post Holder’s role could seem relatively wide however the Post
Holder will see their various roles as being part of the wider delivery of psychiatric services in
a remote and rural area (“rural psychiatry”) rather than attempting to be a multiple mini
specialist.
SPECIALIST PSYCHIATRIC SERVICES
ECT is not provided in the Western Isles Hospital. Patients requiring such treatment would
be transferred to a mainland facility under the terms of an extra contractual, or service level
agreement.
There is no Intensive Psychiatry Care Unit in the Western Isles. Patients requiring this level
of care are transferred to a mainland facility such as New Craig’s Hospital in Inverness. It
will be expected that the Post Holder develop close working relationships with his or her
colleagues in New Craig’s Hospital, Inverness. It will be expected they will be in regular
contact by video conferencing with their colleagues there and travel regularly there for
education, professional development and clinical purposes.
CHILD AND ADOLESCENT MENTAL HEALTH SERVICES
This is service is provided by 3 nurses, 1 support worker and a visiting consultant who
travels from Inverness on a bi monthly basis. The post holder, with their colleague, will
occasionally be asked to input into the care of CAMHS patients, particularly in the absence
of the visiting consultant.
STANDARD ELEMENTS
Confidentiality
Comply with all approved NHSWI Polices and Procedures.
Comply with NHSWI Communication Strategy and Media Strategy.
This involves taking the necessary precautions when transmitting information only disclosing
it to those who have the right and need to know it.
All personal health information is held under strict legal and ethical obligations of
confidentiality.
NHS staff must follow guidance (NHS Code of Practice on Protecting Patient Confidentiality)
before disclosing any patient information. All staff must respect confidentiality of all matters
that they may learn relating to their employment, other members of staff, patients and their
families.
Health and Safety:
Assist in maintaining own and others’ health, safety and security.
This involves:
a) Complying with Board health and safety policies, procedures and participating in
mandatory training.
b) Maintaining a safe working environment and reporting any issues of concern as
appropriate.
NHS Western Isles attaches the greatest importance to the health and safety of its
employees. It is the Board policy to do all that is reasonable to prevent personal injury and
hazard to health by protecting staff and others including the public from foreseeable hazards
compatible with the provision of proper services to patients. The Board expects its entire
staff to take reasonable care of their own health and safety and that of others who may be
affected by their acts or omissions at work. More detailed information is given in
departmental safety policies where appropriate.
Ensure own actions support equality, diversity and rights.
This involves:
a) Acting in ways consistent with the Board’s policies and procedures.
b) Treating those you come into contact with equitably and with respect.
c) Recognising the need for aids or adaptations.
JOB DESCRIPTION AGREEMENT
I, …………………………………………………………….., confirm that the job description and
person specification attached have been discussed with me and are an accurate and up-todate account of the duties and responsibilities and skills/qualifications required to undertake
the post.
Job Holder’s Signature:
Head of Department Signature:
Date:
Date:
PERSON SPECIFICATION
POST: CONSULTANT PSYCHIATRY
FACTOR
ESSENTIAL
DESIRABLE
WORK EXPERIENCE
General Adult Psychiatry.
Experience of managing patients
with learning disability.
Care of Elderly Psychiatry.
Demonstrable leadership skills.
Experience
of
other
specialties in psychiatry.
sub-
QUALIFICATIONS
Professional
MRCPsych
Section 22 Approved
Medical
Practitioner status. If not Section 22
approved, willingness to undertake
training for this.
KNOWLEDGE
SKILLS
AND
Excellent communicator.
Research experience
High level of interpersonal skills.
Experience and skills in telemedicine
Knowledge
legislation.
of
Mental
Health
Competent and effective use of office
IT based systems.
TRAINING
Evidence of continuing personal and
professional development
DISPOSITION
High personal integrity
Commitment to quality of service
Able to work collaboratively
Skills in the provision
psychological therapies.
of