Job Description for the post of ST4 - 6 Trainee in Adult Psychiatry in Newark
(Nottinghamshire Healthcare NHS Trust)
Trainer:
Dr Caroline Innes
Base:
65 Northgate, Newark, Notts, NG24 1HD.
Tel: 01636 670600
Fax: 01636 610861
Introduction
The Newark & Sherwood sector has a total population of 106,000. All community
teams are currently based at 65 Northgate, Newark. There are three consultant
psychiatrists; Dr Innes and Dr Moldavsky, who both work with the Primary Care
Team, Crisis Resolution/Home Treatment Team, the Inpatient Unit, and (for some
patients) the Rehabilitation & Recovery Team; and Dr Lloyd, who works with the
Assertive Outreach Team, the Early Intervention in Psychosis Team, the
Rehabilitation & Recovery Team, and the Newark Community Rehabilitation Unit
which is based at Enright Close in Newark. Cross cover is between Drs Innes and
Moldavsky for the Newark & Sherwood sides of the catchment area respectively, and
both Dr Innes and Dr Moldavsky cover Dr Lloyd's patients from the respective areas
in her absence. Dr Lloyd also has a senior trainee and both Dr Innes and Dr
Moldavsky have two new trainees who are based at Millbrook Unit. There is a
consultant in Old Age Psychiatry (Dr Tomlinson) who is also based in Newark, at
Byron House, and a small general hospital (Newark Hospital).
Facilities
The postholder will be based at 65 Northgate, Newark, for outpatient and community
work and will have the use of a room (shared with another senior trainee and a parttime associate specialist) with computer access, and secretarial support, there.
There is a resource room at Millbrook Unit for the use of medical staff. Psychiatric
library facilities are at Duncan Macmillan House in Nottingham.
Clinical Experience & Responsibilities
1.
Assessment and management of individuals with psychiatric disorders in the
community, working with the Primary Care Team, Rehabilitation & Recovery
Team and the Personality Disorder Service, including direct clinical care of
outpatients, and joint working with colleagues from other disciplines
(psychological therapies, including CBT, psychodynamic psychotherapy,
gestalt psychotherapy, and art psychotherapy). It is envisaged that the
trainee would take on patients with relatively severe and/or complex
disorders, in line with a stepped care approach, but would see individuals with
both relatively brief and longer term illnesses, to obtain experience in
comprehensive psychiatric assessment, team working, and working with
relatives and carers in the community, and would also provide opportunities to
utilise skills in prioritising and time management.
2.
Working with the Crisis Resolution/Home Treatment and the Acute Recovery
Teams in the assessment and care of more acutely disturbed individuals
presenting in crisis with adjustment disorders and also with acute mental
illnesses who require prompt response from mental health services and
relatively intensive input. The CRHT Team have a gate keeping role with
regard to admissions to Millbrook Mental Health Unit, and the AR Team aims
to provide relatively intensive but time limited support for patients around the
time of discharge from hospital and for a relatively short period afterwards,
including day patient services at Enright Close in Newark. The CRHT and AR
Teams are now managed together and it is envisaged there will be more
convergence of their roles in future. The role of the psychiatrist in this team is
to be involved in the assessment of more severe and complex cases, and
may involve prescribing. Some patients under the care of the CRHT Team
will retain input from their regular workers, in addition. There are opportunities
for emergency assessments, including Mental Health Act assessments, and
also psychosocial and psychodynamic assessments of individuals in crisis,
with the opportunity for short term psychological work. There will be the
opportunity to continue involvement with patients, if clinically appropriate, after
an acute crisis, on an outpatient basis.
3.
Inpatient responsibilities include management, under consultant supervision,
of inpatients at Millbrook Mental Health Unit, with the assistance of the junior
trainee. The timetable includes sessions for attendance at ward rounds, ward
work, opportunities to undertake mental health act assessments on inpatients,
and reports for and attendance at Mental Health Review Tribunals and
managers’ panels, and participation in risk assessment and discharge
planning.
4.
Educational responsibilities include regular informal and more structured
teaching of medical students, and the provision of informal supervision and
support for the junior trainee.
5.
Participation in the on-call rota covering Millbrook Mental Health Unit out of
hours, with support from a junior trainee and a consultant psychiatrist.
6.
Participation in the senior trainee rota covering the Section 136 Suite at
Millbrook Mental Health Unit.
This post provides an opportunity to work across several teams and therefore obtain
an overview of service working which would be useful for someone interested in
management and service development. The catchment area is a small town with a
rural hinterland, with the more easterly Nottingham suburbs at one end. Work with
the CRHT Team tends to involve home visits, but there would also be facilities for
patients to be seen elsewhere if appropriate, usually at 65 Northgate, Newark.
Academic Activities
There is a weekly educational meeting at Millbrook Mental Health Unit on Monday
lunch times (lunch provided), attended by junior and senior trainees, consultants,
associate specialists and medical students.
There are presentations (case
presentations and journal articles) by junior doctors and the senior trainees are
expected to chair the meetings on a rota. There is a weekly educational meeting in
Nottingham on Wednesday lunch times at which attendance may be possible. There
is provision in the timetable for one day a week for research or special interest, and
study leave. There is a psychiatric library at Duncan Macmillan House, Nottingham,
and computer access at 65 Northgate, Newark, with access to online journals. The
trainee will be expected to find a research supervisor. Participation in audit will be
encouraged.
Supervision
There is a 1 hour weekly slot for the supervision by Dr Innes, as detailed in “Trainee
and Trainer Timetables”.
General Adult Psychiatry Competencies
This post offers opportunities to achieve the following competencies
1.
Specialist psychiatric assessments, including full psychiatric history and
examination, risk assessment, differential diagnosis and formulation. This
will be assessed by CBD, ACE, mini-ACE and supervisor’s report.
2.
Development of appropriate management plans including relevant
investigations, drug and psychological treatments, referral to colleagues
and decisions about access to specialist therapies. This will be assessed
by CBD, ACE, mini-ACE and supervisor’s report.
3.
Writing reports and attending Mental Health Review Tribunals and
Managers’ Panels. This will be assessed in clinical supervision and by
CBDs.
4.
Assessment of psychiatric emergencies (including use of the Mental
Health Act). This will be assessed by supervisor’s report, mini-PAT, CBD
and if possible by ACE.
5.
Multidisciplinary and team working and leadership skills.
The trainee will be expected to be a regular member of the Crisis
Resolution Home Treatment team and to attend handovers and team
meetings in the sessions for which he/she is scheduled to work with the
team, and to take a lead role in devising medical management plans. This
will be assessed by CBD, mini-PAT and supervisor’s report.
6.
Teaching, appraising and assessing. The trainee will be expected to teach
medical students in clinics and in small group teaching sessions, and will
have the opportunity to participate in medical students’ OSCEs. The
trainee will also be expected to provide some supervision for junior
colleagues working with Dr Innes and Dr Moldavsky, and junior colleagues
on the on-call rota, and to participate in their Workplace-Based
Assessments. This will be assessed by mini-PAT and supervisor’s report.
7.
Understanding research methodology. The trainee will be expected to
chair educational meetings, including journal clubs, on a rota with the other
senior trainees, and to discuss the critical appraisal of the article presented
with the relevant junior trainee beforehand. The trainee may have the
opportunity to present his or her own research at one of the Wednesday
educational meetings in Nottingham. This will be assessed by CBD,
supervisor’s report, and mini-PAT.
8.
Professionalism, including record-keeping, communication, relationships
with patients, colleagues, GPS and other agencies, and time
management. This will be assessed by mini-PAT, supervisor’s report and
CBD.