NW Thames Foundation School
Individual Placement Description
Placement
FY1 Liaison Psychiatry
The
department
The Dept of Psychological Medicine is a lively, progressive
department which includes both liaison psychiatry and clinical
health psychology. The liaison psychiatry service provides 24h
psychiatry service to the acute wards and emergency dept at
Northwick Park Hospital. We receive about 70 new referrals a
week and undertake to respond rapidly (within 1 hour to ED, and
24h to the wards). We are involved in all aspects of patient care,
from diagnostic assessments, to advice on medical and
psychological management, to discharge planning, functional
assessment and arranging appropriate community care. We see
patients of all ages from 16 upwards, including the elderly. We
have a strong community-facing focus which includes regular
contact with primary care, community mental health, social
services community addictions and non-statutory services. The
team is led by two consultant psychiatrists. At least one
consultant is present on-site every day. A team of 12 nurses
provide 24h clinical cover.
Trust & Site
Northwick Park Hospital, Central & North West London NHS
Foundation Trust
The type of
work to expect
and learning
opportunities
The F1 doctors will work as members of the multidisciplinary
team, seeing new referrals and following up patients under the
supervision of the consultant. The doctors will be encouraged to
undertake programmed Supervised Learning Activities SLEs and
Work Place Based Activities in accordance with the Foundation
Curriculum. By the end of the post the doctors will have
experience of taking a psychiatric history, mental state
examination, risk assessment, formulation and diagnosis, and the
use of multimodal treatments including medicines, psychotherapy
and social support.
For all the people we see, it is essential that medical,
psychological and social aspects of a patient’s care are
considered. The doctors will gain experience of the psychosocial
aspects of a range of long-term conditions - including dementia,
diabetes, respiratory and cardiac conditions and substance
misuse disorders - and learn how to integrate them into clinical
formulations and management plans.
FY doctors in our dept will be supported closely during their initial
weeks and encouraged to take increasing responsibility for
clinical assessment and decision-making in an incremental
manner which encourages the development of confidence,
maturity, independence and the ability to manage and contain the
uncertainty which is inherent in all areas of medical practice.
Contact/liaison with primary care is necessary for almost every
patient we see, and we need to make appropriate onward
referrals for follow-up. The doctors will also have experience of
joint working and close liaison with other medical specialties and
a range of community services including primary care, community
mental health, social services, addiction services and nonstatutory services. By the end of the post the doctors will have an
understanding of the range of community mental health services,
and also appreciate the role of non-statutory services (for
example, services for the elderly, bereavement counselling,
employment advice, immigration / asylum support). The doctors
will have gained skills in communicating clearly clinical opinion
and recommendations to colleagues in other specialties and
disciplines, and resolving any disagreements which may arise in
day-to-day working.
All doctors will be offered information and advice about careers in
psychiatry. Doctors who wish to pursue a career in psychiatry will
be supported in relevant professional development, e.g.
undertaking audit or attending relevant in-house training courses.
Clinical
Supervisor(s)
for the
placement
Dr Alex Thomson, consultant liaison psychiatrist, and Dr Justin
Kington, consultant older adults liaison psychiatrist, will schedule
1h weekly supervision time. In addition, the doctors will receive
close clinical supervision, including observation of patient
interactions within the workplace-based assessment framework.
Internal cover for consultant leave is provided among the three
consultant liaison psychiatrists at Northwick Park and Central
Middlesex Hospitals
Main duties of
the placement
The FY1 doctors will be responsible for responding to psychiatry
referrals from the medical wards and emergency dept, and for the
ongoing care of a limited caseload of hospital inpatients.
Following initial assessment and making provisional management
plans, they will have the opportunity to discuss cases and return
with a consultant supervisor to see the patients. A consultant
liaison psychiatrist is present on-site Mon-Fri 9am-5pm. Outside
of these hours, support and supervision is available on site from
the CT doctor in psychiatry, and from psychiatric liaison nurses
and the specialty doctor within the team. Senior non-resident
support is also available out of hours from the on-call psychiatry
ST doctor / specialty doctor and consultant.
The doctors will work as part of a multidisciplinary mental health
team alongside the acute medical and nursing teams to deliver
integrated care. Close liaison with home treatment services from
mental health, acute medicine and social services is necessary
for effective and safe discharge planning. The liaison psychiatry
team has a daily multidisciplinary clinical meeting which will allow
the doctors to gain understanding and experience of different
professional roles.
There are weekly teaching programmes within the dept and the
Mental Health Unit. There are also opportunities to present at
grand rounds and journal clubs, which the F1 doctors will be
encouraged to take advantage of. Northwick Park Postgraduate
Training Centre has a library on site. A computer with internet
access will be available in the liaison psychiatry office.
Typical
working
pattern in this
placement
The post will be banded at 1A, i.e. 50% supplement, on a 4weekly rota with late shifts and evening shifts in a similar manner
to an emergency dept rota.
Daily:
0915 Management Round
Wednesdays:
12:30 Department teaching
13:30 Mental Health Unit teaching programme
16:00 Interprofessional on-call supervision group (fortnightly)
Alternate Thursdays:
12:30 Team meeting
See below for example timetable.
On call requirements: Full shift, no on-call requirement.
Employer
information
The employer for this post is London North West Hospitals NHS
Trust and the trainee will have an honorary contract with CNWL
It is important to note that this description is a typical example of your placement and may be
subject to change.
TIMETABLE
Average weekly hours: 46.37. Banding: 1A EWTD compliant, New Deal compliant
As this is a newly created post, the timetable is indicative and there is scope for
flexibility according to individual preference and the needs of the service, e.g. of which
weekdays to take off or exact rota pattern.
Example timetable:
Mon
09001700
Mgmt
Round
+ ward
work
Tues
09001700
Mgmt
Round +
ward
work
Mon
1400-2200
Ward work
Mon
11001900
Ward
work
Mon
09001700
Mgmt
Round
+ ward
work
Wed
0900-1700
Mgmt Round
ward work
12.30-13.30
Team Training
1330-1700
Academic prog
Tues
1400-2200
Ward work
Tues
11001900
Ward
work
Tues
09001700
Mgmt
Round +
ward
work
Thu
Fri
Sat
0900-1700
0900OFF
+ Mgmt Round + 1700
ward work
Mgmt
12.30-13.30
Round +
Team Meeting
ward
1400-1500
work
Clinical
Supervision
Wed
1330-1700
Academic
Prog
1700-2200
Ward work
Wed
1100-1900
Ward work
12.30-13.30
Team training
1330-1700
Academic
(SPA)
Sun
OFF
Thu
1400-1500
Clinical
Supervision
1500-2200
Ward work
Fri
1400-2200
Ward work
Sat
OFF
Sun
OFF
Thu
1100-1900
Ward work
1400-1500
Clinical
supervision
Fri
1100-1900
Ward work
Sat
09002100
Ward
work
Sun
09002100
Ward
work
Sat
OFF
Sun
OFF
prog
Wed
Thu
Fri
0900-1700
0900-1700
OFF
Mgmt Round + ward Mgmt
work
Round
+
12.30-13.30
ward work
Team training
1400-1500
1330-1700
Clinical
Academic
prog supervision
(SPA)