December 2005
To Whom It May Concern:
The following document is a job description for a dedicated SpR post in Liaison Old Age
Psychiatry which I prepared around November 2004 and which was approved by the College
as a Core Old Age Psychiatry placement. I’m happy for anyone to use this as a template for
future applications and hope it is of some help.
We currently have no local funding for the post, but were able to appoint an SpR from
August 2005 to July 2006 who had a particular interest in LOAP, who was not able to obtain
training locally, and who negotiated an inter-deanery transfer from her rotation.
I am currently looking into ways of securing local funding for the post, but in the meantime
would be interested to hear from any SpR who thinks that they may be able come over on a
similar arrangement. There are currently few posts offering dedicated LOAP training at SpR
level (even as a special interest session), but hopefully this will change with time.
If any questions, please contact me at the address below
Rob Stewart
Senior Lecturer and Consultant in Liaison Old Age Psychiatry
Address: Section of Epidemiology (Box 60), Institute of Psychiatry, De Crespigny Park,
London SE5 8AF.
Phone: 020 7848 0136
Fax: 020 7277 0283
Email: r.stewart@iop.kcl.ac.uk
Post No.
Location: Croydon, Liaison Old Age Psychiatry.
Consultant Trainer
Dr R. Stewart
No. sessions
Liaison Old Age Psychiatry: 5
sessions
Special Interest
Research: Epidemiology
and Old Age Psychiatry
Specialist Registrar Post in Liaison Old Age Psychiatry – Job description
The Specialist Registrar Post in Liaison Old Age Psychiatry (LOAP) in the South London and
Maudsley NHS Trust (Croydon sector) will be under the direct supervision of Dr Robert
Stewart, who contributes five clinical sessions per week. Dr Stewart has an honorary
consultant contract with the South London and Maudsley NHS Trust and has CCST
accreditation in Old Age Psychiatry.
The service: A dedicated LOAP service to the Mayday and Purley hospitals in Croydon was
set up in September 2002, and has expanded considerably in terms of staff, workload and
service activity since then. A key objective of the service is the development of close working
relationships with both colleagues in community Old Age Psychiatry and medical/surgical
teams at the Mayday Hospital. The service receives referrals from both services, and staff
attend both psychiatric and medical/surgical multi-disciplinary management round meetings
(MDMs) as required to facilitate continuity of care. The LOAP team consists of a consultant
(5 sessions), a staff grade psychiatrist (8 sessions), a clinical nurse specialist (full-time) and
an administrator (8 sessions). The service has also provided special interest sessions for
specialist registrars since its inception. The Mayday and Purley hospitals cover the Croydon
district in south London (approximately 330,000) and have 689 general/acute beds, of which
on average 390 are occupied by inpatients aged 65 or over. The LOAP service received 268
referrals in the second year of its operation (Sep 03 – Aug 04) but referral rates have been
increasing steadily over this period and are currently between 20-30 per month.
Approximately 60% of referrals require further follow-up by the service and the caseload
averages 20 clients at a given time. Approximately 50% of referrals are from Elderly Care
teams (who cover the 78+ age range). All acute beds are based at the Mayday Hospital. A
further two Elderly Care rehabilitation wards are based at Purley Hospital and are due to be
relocated to the Mayday site within the next 2-3 months.
The role of the trainee: The SpR will work with the LOAP team in providing a liaison
psychiatry service for the Mayday Hospital. The SpR will have office space at the Queens
Resource Centre (which is situated close to the Mayday Hospital and is also the base for two
community Old Age Psychiatry teams), with dedicated secretarial and administrative
support. The SpR will assist in the assessment and (if necessary) ongoing management of
routine consultation referrals. They will also attend a weekly MDM for one Elderly Care team,
picking up referrals directly from team members and carrying out a clinical assessment or
providing advice where necessary. A further weekly MDM will be attended for a specialist
Elderly Care service. This will be discussed at the beginning of the placement and will be
modified according to the trainee’s needs, but is likely to include six months working with the
Mayday orthogeriatric service (rehabilitation after fracture) and six months with the stroke
care service. The SpR will also work with one of the general Old Age Psychiatry teams,
picking up direct referrals from that service (for clients who are currently inpatients at the
Mayday Hospital) and attending community and inpatient team meetings as appropriate. The
trainee as will be encouraged to participate in medical and nursing training programmes at
the Mayday Hospital, a core component of LOAP work. The SpR will have a weekly one
1
hour supervision session with Dr Stewart. In addition to these fixed supervision sessions. Dr
Stewart will also attend MDM sessions with the SpR on a rotating basis.
SpR Timetable:
Monday
Tuesday
Wednesday
Thursday
Friday
Special
interest
General liaison
MDM
Specialty
liaison MDM
(orthogeriatrics
or stroke care)
Liaison team
multidisciplinary
meeting
Special
interest
Clinical
assessments
Attend CMHT
meeting
2-3pm
Research
Supervision
with
Dr
Stewart
am
Research
pm
Clinical
assessments
Teaching
duties
On-call (please state frequency of oncall)….…………………………………………………………………….
……………………………………………………………………………………………………………………...
Consultant Trainer’s timetable
Monday
Tuesday
Wednesday
Thursday
Friday
am
MSc teaching
Clinical
assessments
Research
Liaison team
multidisciplinary
meeting
Research
Teaching and
academic
management
Clinical
assessments
Clinical
management
2-3pm
Supervision of
SpR trainee
Research
pm
3.30-4.30pm
Supervision of
staff grade
2